October 3, 2022

5 Questions to Ask After a Fall

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In the United States, about 1 in 4 adults age 65 and older reports falling each year. While some tumbles are less serious, about 37% of falls in this older adult population may require medical attention and treatment. But often, getting to the root cause of the fall can be just as important as treating a resulting injury, because knowing the likely culprit of your fall may help to prevent the next one. Here are some questions you can ask to help guide your conversation with your physician after a fall.

“How’s my blood pressure?”

It’s not uncommon to experience a little lightheadedness when standing up too quickly; but if it happens often, it could indicate a blood pressure condition known as orthostatic hypotension. For this reason, measuring your blood pressure while sitting or lying down and then again after standing up — otherwise known as your orthostatic blood pressure — should typically be a key part of any fall risk assessment.

Blood pressure medication itself can increase the risk of orthostatic hypotension, which is why this condition can be common in certain older adults. If you suspect lightheadedness or fainting may have caused or contributed to your fall, ask your doctor to evaluate you for orthostatic hypotension. While you’re there, you could ask if you also may need a blood test. Some studies have indicated that factors such as hemoglobin levels and electrolytes can also impact fall risk.

“Could my balance be an issue?”

Gait and balance tests may be a useful tool for a physician to assess the risk of falls caused by certain factors such as strength, balance and/or gait (the pattern of your walk). During these tests, the physician may look for signs of pain or discomfort when walking that increase the likelihood of a fall. If your doctor notices unusual gait or lack of balance, ask them to recommend strengthening exercises. You may also ask if they’d recommend an assistive device, such as a walker, or physical therapy to help target any weak muscles.

“Do I need more vitamin D?”

Some studies suggest that treatment of low vitamin D levels may help to decrease an older adult’s risk of a fall, as well as the risk of breaking a bone when a fall occurs. If you spend a lot of time indoors, it’s possible that you’re low in this vitamin, which the body naturally produces when exposed to the sun’s UV rays. According to one study, vitamin D supplementation could reduce fall risk by 23%.

“Do you suspect any new underlying conditions?”

Although generally less common, some older adults may fall because of an undiagnosed underlying condition related to the heart or the brain. One such condition is paroxysmal rapid atrial fibrillation, which causes the heart to race intermittently and which may affect blood pressure, and which has been associated with causing falls. Falls may also sometimes be precipitated by an underlying neurological condition such as Parkinson’s disease.

“Do I really need to take all of these medications?”

Sometimes, the older we get, the more our pillbox fills up. But some of the medications commonly prescribed to older adults may also increase their risk of a fall. These may include some anti-anxiety drugs, tricyclic antidepressants, certain prescription sleep drugs, narcotics, and even certain prescription medications that treat overactive bladder. In fact, the more drugs you take, the more likely it is that one or a combination of them could cause a fall, Harvard Health Publishing reports.

Adverse drug reactions cause about 1.3 million emergency room visits each year, and older adults visit the emergency room about twice as often as younger people due to adverse drug events. If you take multiple medications and are concerned about falling or other adverse drug events, you may want to consider seeing a geriatrician, a primary care physician who specializes in aging and who typically has expertise in medication management and fall risks.

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