Over 400,000 older people in England attend A&E Departments following an accident and up to 14,000 people a year die in the UK as a result of an osteoporotic hip fracture.
Osteoporosis, a condition characterised by a reduction in bone mass and density increases the risk of fracture when an older person falls. Fractures occur most commonly in the hip, spine and wrist. Vertebral fractures due to osteoporosis can cause loss of height, curvature of the spine and chronic back pain. One in three women and one in twelve men over 50 are affected by osteoporosis and almost half of all women experience an osteoporotic fracture by the time they reach the age of 70.
Most falls do not result in serious injury, but the consequences for an individual of falling or of not being able to get up after a fall can include:
- Psychological problems, for example a fear of falling and loss of confidence in being able to move about safely
- Loss of mobility leading to social isolation and depression
- Increase in dependency and disability
- Hypothermia
- Pressure-related injury
- Infection.
A fall can precipitate admission to long-term care. After an osteoporotic fracture, 50% can no longer live independently. Fear of falling can provide a significant limitation on daily activities. Falls in a later life are also a common symptom of previously unidentified health problems which need be identified and managed.
Hip fracture is the most common serious injury related to falls in older people, resulting in an annual cost to the NHS of around £1.7 billion for England. Of this, 45% of the cost is for acute care, 50% for social care and long-term hospitalisation and 5% for drugs and follow up.
Risk factors for falls
- Lower limb weakness
- History of falls
- Gait/balance problem
- Visual impairment
- Arthritis of lower limb joints
- Postural hypotension
- Polypharmacy, i.e. four or more drugs
- Cognitive impairment
- Incontinence
- Age over 65
Common causes of postural hypotension (dizziness when you stand up)
- Drugs
- Dehydration
- Anaemia
- Sepsis
- Alcohol
- Prolonged bed rest following illness
- Carotid sinus disease
- Autonomic failure
- Adrenal insufficiency
Risk factors in the home environment include:
- Poor lighting, particularly on stairs
- Steep stairs
- Loose carpets or rugs
- Slippery floors
- Badly fitting footwear or clothing
- Lack of safety equipment such as grab rails
- Inaccessible lights or windows.
Rehabilitation should aim to:
- Increase the older person’s stability during standing, transferring, walking and other functional movement by:
– balance training
– strengthening the muscles around the hip, knee and ankle
– increasing the flexibility of the trunk and lower limbs
If you have concerns about yourself or someone you care for please contact us and consult one of our chiropractors.