Falls in the older adult

Hello!

Todays blog is focusing on the falls in the older adult. The following statistics have come from the CSP’s Physiotherapy Works: Falls a community approach 2019 (1).

  • Fear of falling affects ~50% of older adults who have fallen and up to 50% who have never fallen
  • 1/3 of over 65’s fall at least once a year. This increases to 50% for those over 80
  • Falls with injury = leading cause of mortality
  • Following a fall, 50% of older adults have mobility impairments and there is a 10% probability of dying within a year

This is a shocking figure!

Economically:

  • The cost of falls to the NHS in England due to hazards in the home environment is £435 million (1). 
  • The cost to the NHS is thought to be more than £2.3 billion per year (1).

Effects of lockdown

Lockdown has no doubt lead to increased falls due to reduced mobility and social activities. Ultimately this will lead to more deaths. A hidden killer in COVID times.

A study by UCL (2) has shown that elderly people who live alone and have limited social contact are more likely to fall. They had 13,061 participants with data collection over a period of several years. Those living alone had an 18% greater risk of reporting a fall than those living with a friend or relative. Older adults with the least social contact were 24% more likely to report a fall . During lockdown elderly have been more isolated so this could translate to there being more falls. Studies have shown that mechanical unloading of muscles resulting from periods of inactivity may lead to a transient exacerbation of age‐related muscle waste, increasing the progression of sarcopenia and the development of comorbidities (3) (4) (5). Interestingly an analysis of data from FitBit has shown that there has been a reduction in steps ranging from 7%-38% in European countries during the week ending 22nd March 2020 (5)(6). Lockdown has definitely resulted in reduced activity for all. Although its too soon to learn the real cost of COVID on the elderly in relation to falls, its clear that it could be high.

What can we do?

We know that Physiotherapy can help:

  • Physio can result in a 24% reduction in falls with a multi-factorial falls assessment
  • Providing an exercise programme can result in a 34% reduction in falls
  • This can reduce fear of falls and improve function + mobility. (1)

Its important we act now to intervene and help reduce this probable hidden killer of COVID.

References

  1. https://www.csp.org.uk/publications/physiotherapy-works-falls-community-approach
  2. A longitudinal analysis of loneliness, social isolation and falls amongst older people in England. F,Bu et al. Scientific Reports volume 10, Article number: 20064 (2020) 
  3. Hartley P, Costello P, Fenner R, et al. Change in skeletal muscle associated with unplanned hospital admissions in adult patients: a systematic review and meta‐analysis. PLoS One. 2019; 14:e0210186
  4. Bell KE, Von Allmen MT, Devries MC, Phillips SM. Muscle disuse as a pivotal problem in sarcopenia‐related muscle loss and dysfunction. J Frailty Aging. 2016; 5: 33‐ 4110 
  5. Blog FITBIT. FITBIT News: The Impact of Coronavirus on Global Activity [Internet]. https://blog.fitbit.com/covid-19-global-activity/. Accessed 13/1/2021
  6. Risk of Increased Physical Inactivity During COVID‐19 Outbreak in Older People: A Call for Actions. Hamilton Roschel PhDGuilherme G. Artioli PhDBruno Gualano PhD First published: 11 May 2020 https://doi.org/10.1111/jgs.16550 Accessed 13/1/2021

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