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Elder Care News
Preventing Falls May Be Key to Avoiding Disability
in Elderly
By Patricia McAdams, Contributing Writer
Health Behavior News Service
September 8, 2006 - Physical inactivity, depression
and falls all increase risk of developing a disability in later life.
But targeting falls may be a particularly effective way to reduce the
nation’s disability levels, according to a new study.
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Elder Care News |
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Fall-prevention efforts that combine education
about risks with exercise, home safety and health assessments offer the
most promise, at least in the short run, found researchers led by Vicki
Freedman, Ph.D., a professor at the University of Medicine and Dentistry
of New Jersey.
Freedman and her colleagues compared three
strategies to reduce late-life disability: increasing physical activity,
identifying and treating depression and avoiding falls. Their findings,
published in the current issue of the The Milbank Quarterly, arise from
a review of more than 100 intervention studies.
The review found that fall prevention efforts
targeted at frail adults can reduce the risk of falling and related
injuries by about 25 percent. Community-wide efforts that have been
tested abroad were shown to reduce fall-related fractures by 6 percent
to 33 percent.
“Both medical and environmental aspects of
disability need to be addressed in a disability prevention program,”
Freedman said. “Approaches that recognize the complexities of disability
appear to be more successful than those that address only a single
factor.”
About one-third of people aged 65 or older — or
nearly 12 million people — experience falls, said Freedman. Of these,
about 20 percent to 25 percent experience severe injuries or
limitations.
Traditional health insurance programs may address
medical aspects of a disability, but they rarely fund home safety
changes or assistive technologies that may help an older adult live
independently. The researchers call for additional research that
considers how best to finance and deliver a multicomponent disability
prevention program.
“Ideally, such an effort should consider not only
which components to target, but also which audiences to target — older
adults, their families, providers or perhaps entire communities.”
Freedman said she was surprised how little evidence
she and her colleagues could find about the likely long-term effects of
different intervention strategies. Most studies lasted less than a year.
This scarcity of evidence is significant, she said, because conclusions
about the long run could be very different.
Jon Pynoos, Ph.D., co-director of the Fall
Prevention Center of Excellence, said that the review correctly
identified medical risk assessment/management, physical activity and
environmental modifications as the “big three” interventions capable of
significantly reducing falls.
“Now we need to create ‘real-world’ programs that
combine these elements and make them available to persons at moderate to
high risk of falls who need them,” he said.
Pynoos said that one challenge is coordinating
components from various fields — such as medicine, exercise and home
modifications — with different eligibility requirements, reimbursement
systems and approaches. It is also important to understand what “dose”
effect or level of each intervention is needed to have an impact, he
said.
“At the Fall
Prevention Center of Excellence, we are working to create sustainable
community-based programs that will serve as models that can be
replicated in various settings,” Pynoos said.
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