THE FALL IN THE ELDERLY

The aging process is associated with several changes that predispose to falls. Falls are a result of any event that precipitates the patient down against your will. This will occur in the elderly with high morbidity and mortality. The fall is the interaction between risk factors (chronic diseases, impaired balance and gait, drugs, etc..) And exposure to risks or opportunities falling to be taken into consideration together. Also remember that there is an unpredictable or unavoidable fact therefore prevention plays a very important role.


The elderly often accept it as an inevitable part of aging and therefore frequently fail to inquire about this.
The fall of an elder is not an unpredictable or unavoidable due to chance or normal aging individual. In most cases it is a mismatch between the old man and his environment.
The house is where falls happen most frequently, highlighting the bedroom, bathroom and stairs.

FACTORS THAT CAUSE THE FALL IN THE ELDERLY

• Chronic diseases 

• Visual disturbances

• Vestibular System: The loss of age-related balance, can occur as a result of osteoporosis, it can also occur from trauma, ear infections and drug consumption.

• Locomotor system: musculoskeletal disorders associated directly or indirectly with age, and foot problems may be a cause of disturbance of equilibrium and gait, and thus lead to falls.

• Neurological system: Structural changes in the cerebral cortex, either vascular or degenerative disorders of the pyramidal tract, extrapyramidal or cerebellar, are major causes of gait instability.

• Acute Diseases: The infectious, and exarcerbación of some chronic diseases such as congestive heart failure, may precipitate falls.

• Polypharmacy: The 81% of the elderly take their medication and the 2/3 parts over a drug ingested regularly. This figure increases with age, and so 30% of those over 75 years take more than 3 drugs.

• Misuse of drugs: together with the presence of comorbidity, is that advese reactions are more frecuent among the elderly, and therefore increases the risk of falls.

DRUGS THAT CAUSE FALL

1. Benzodiazepines.
2. Antihypertensives: Considered second only to the sedatives, may influence falls or postural hypotension by decreasing cerebral blood flow.
3. Diuretics: For hypotension especially when they are used in cardiac diseases.
4. Phenothiazines: Your reactions are extrapyramidal and parkinsonism. Can you explain some association with falls.
5. Tricyclic antidepressants increases the propensity to fall especially when combined with other drugs that cause postural hypotension, and its main exponent Imipramine. Besides this group caused heart rhythm disorders and anticholinergic effects may be involved in falls among the elderly.
6. Nonsteroidal anti-inflammatory drugs: instability and confusion.

Considering the amount of drugs that cause instability and insecurity in the elderly, we must be wary of imposing treatment where these drugs are combined, because of a potential fall that entails.

In conclusion, in this case is very important the prevention of falls, and they can save a lot of problems for the elderly.

BIBLIOGRAPHY:

Días Grávalos, G. Gil Vázquez, C. Andrade Pereira, V. Alonso Payo, R. Factores asociados con la aparición de caídas en ancianos institucionalizados: un estudio de cohortes, 2009. Revisado en: http://www.elseiver.es/en/node/2080328

André da Silva Gama, Z. Gómez Conesa, A. Sobral Ferreira, M. Epidemiología de caídas en España, 2008. Revisado en: http://scielo.iscii.es/scielo.php?script=sci_arttext&pid=S1135-57272008000100004&Ing=es&nrm=iso&tIng=es