How to prevent broken hips

Help with vision and balance may mean fewer falls.

You reach old age, you fall, or so it is widely believed. But new findings show that falling need not be as inevitable as white hair when we get older. A Yale study has found that making fall prevention a regular part of healthcare for older adults will go a long way towards preventing serious injuries.

Previous pilot studies at Yale and other medical centers have demonstrated that for the elderly, the risk of falling can be predicted based on a number of risk factors, including a person's medication mix, vision problems, foot issues, and trouble with walking and balance. Managing and reducing those risk factors reduced fall-related injuries by more than 30 percent under research conditions. Now Yale geriatrics authority Mary E. Tinetti, who led several of those past experiments, has shown that the same techniques can also prevent falls in a real-world setting. (The study was published in the July 17 issue of the New England Journal of Medicine.)

First, Tinetti's team produced a media campaign in the greater Hartford region about preventing falls. They also trained 3,000 area healthcare providers and administrators to assess and reduce older patients' risks for falls. Compared with the control group of similar hospitals, the number of patients needing emergency care declined by 11 percent and the rate of serious injury by 9 percent. That translates into 1,800 fewer emergency visits.

Nationally, fall-related injuries account for 10 percent of all emergency department visits and 6 percent of hospitalizations among persons over the age of 65. The injuries and debility resulting from falls can lead to functional decline, nursing-home placement, restricted activity, and early death. Therefore, getting clinicians to assess their patients' falling risks, and then taking steps to help reduce those risks, says Tinetti, "should really be part of good health care for all older people. The research is done. It's time to put what we know into action."

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