Fall prevention | TheUnion.com

Fall prevention

Dr. Peter Zeischegg
Special to The Union

Among people 65 years old and older, falls are the leading cause of injury deaths and the most common cause of nonfatal injuries and hospital admissions for trauma.

Each year in the United States, nearly one-third of older adults experience a fall. Of those, one-third break the hip and are hospitalized, dying within a year.

The U.S. Centers for Disease Control and Prevention estimates more than $19.2 billion is spent every year on treating the elderly for falls, including $12 billion for hospitalization, $4 billion for emergency department visits and $3 billion for outpatient care.

Even if the fall does not result in hospitalization, fear of falling becomes a major factor. Fear typically leads to a person becoming less active, less social and more isolated. Many falls, and the fear of falling, could be prevented through screening and appropriate treatment.

The ability to walk upright on two feet in Earth’s gravitational field and to maintain balance is an extraordinary accomplishment unique to human beings. It requires a well-functioning brain and nervous system.

We all tend to take this for granted – until we lose our balance, experience dizziness or vertigo, and fall.

Your brain’s main function is to determine where you are in space and where space is in relation to you. That lets you move intentionally and gracefully, distinguish your right hand from your left hand, and keep your balance.

Your brain receives feedback about your position in space primarily from three distinct sources: From your eyes (vision); from countless tiny receptors in your muscles called muscle spindles, and from receptors in your joints, ligaments and tendons (proprioception); and from the balance system in your inner ears, (vestibular labyrinth).

Your brain processes this feedback and sends appropriate responses to your muscles. You need a healthy brain to do that.

A “bad” brain will fail. A drunk person is a great example. Alcohol depresses your brain function. When you’re drunk, your balance is impaired; you cannot walk gracefully; you sway and stagger; you may fall.

In addition, you need a healthy spinal cord and peripheral nerves so that this feedback can reach your brain, and your brain’s response can reach your muscles. Your muscles must be strong to respond quickly and appropriately to your brain’s signals.

Here are some factors that increase your risk of falling:

• Decreased brain function from aging, alcoholism, smoking, chronic illness and malnutrition.

• Pharmaceutical medications: The Physicians’ Desk Reference (PDR) lists more than 1,000 medications with vertigo and dizziness as side effects.

• Visual disturbances.

• Dizziness/vertigo from inner ear problems.

• Muscle weakness and loss of muscle tone.

• Loss of sensations in legs and feet, as in diabetes.

• Postural hypotension: Drop in blood pressure with decreased blood flow to your brain when getting up from lying or sitting.

The first and most important step towards fall prevention is to assess your risk of falling, and if indicated, to identify appropriate fall prevention strategies and treatments.

A fast and highly accurate screening tool is CAPS, a computerized posturography falls-risk detection equipment. CAPS can identify an at-risk person in less than 60 seconds and quantify the degree of his or her risk according to age-based reference values.

As a community service, I offer this CAPS fall risk screening free of charge.

Dr. Peter Zeischegg, MS, DC, DACNB and board-certified chiropractic neurologist, can be reached at (530) 265-0224; or visit DrZ.org.

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