Falls can be catastrophic for older people, but even when they’re not, they can cause injuries, suffering, stress, long-term disability, and lack of confidence in whether a person can continue to live independently at home.There are, of course, many ways to prevent falls or to mitigate their impact. We’ve previously discussed home modifications that minimize the risk of falls, and we’ll definitely discuss that again. But today, we want to take a look at why seniors are more physically vulnerable to falls and what they can do to help themselves stay healthy and upright.According to the National Institute on Aging, a division of the National Institutes of Health, the risk of falling rises with age; indeed, more than one in four people aged 65 years or older fall each year. Here are some of the reasons why that might happen, along with a few possible solutions at the end.Balance issuesBalance problems are a major factor in falls, and they are common due to the complex way our bodies achieve balance. According to the UCLA Health website, https://www.uclahealth.org/news/article/balance-begins-to-decline-as-early-as-age-50 our eyes orient us in space while our musculoskeletal systems provide kinesthesia, or the body’s ability to sense its own movement and location. Besides that, the “intricate” vestibular system in our inner ears tell us how our heads are positioned, where we are in space, and how (and how quickly) we are moving.Balance happens when our brains process all of this input simultaneously—and that means that small disruptions to any of those systems can affect a person’s balance. Another major factor in achieving balance is musculoskeletal strength and flexibility; as UCLA Health points out, “Good balance relies on the muscles of the feet, legs, buttocks, abdominal, and torso. And, yes, that’s basically the entire body.”SarcopeniaThat brings us to sarcopenia, the progressive loss of muscle mass and strength that can happens with age. Everyone loses some muscle as they grow older, but sarcopenia happens at an accelerated pace. Because loss of muscle mass is a natural part of the aging process, sarcopenia cannot be entirely halted. In addition, that loss of muscle starts earlier than people think, according to an article by the Cleveland Clinic: https://my.clevelandclinic.org/health/diseases/23167-sarcopenia muscle mass degradation begins as early as the 30s and 40s for most people, picking up speed between the ages of 65 and 80.However, sarcopenia is greatly accelerated by factors including physical inactivity, obesity, chronic disease (diabetes, cancer, HIV, COPD, and the like), rheumatoid arthritis, reduction in hormone levels, malnutrition or inadequate protein intake, and more.Vision and other sensory issuesIt’s a well-known “grandma and grandpa” stereotype to think of older people with reading glasses perched on their noses. But it’s a stereotype based in reality: the National Institute on Aging https://www.nia.nih.gov/news/take-care-your-senses-science-behind-sensory-loss-and-dementia-risk#:~:text=About%20one%20third%20of%20older,blow%20to%20quality%20of%20life. reports that a third of older adults have vision problems or vision loss by age 65. And that’s not the only “sense” to suffer with age: the same article notes that almost half of people older than 75 have disabling hearing loss, while others suffer from anosmia, the decline or loss of the sense of smell.All of these can be “a significant blow to quality of life,” the NIA article states—there is evidence that vision deficits are lined to certain types of dementia and Parkinson’s disease, and vision loss can also lead to increased social isolation. Similarly, there is growing evidence that unaddressed hearing loss can contribute to cognitive decline in older adults, as well as increased isolation and loneliness due to dropping out of social events or conversations because of the struggle to hear clearly. This isolation can actually accelerate the shrinkage of the brain’s sound processing areas. Researches also find that smell may actually be the sense most closely linked with memory, “and declining smell sensitivity can foretell dementia” and could be an “early warming sign” of neurodegerative diseases. When these senses decline at the same time, the effects of their loss are compounded and can include increased likelihood of falling.Postural hypotensionNearly everyone has had the experience of feeling faint or dizzy when standing up after sitting or lying down. It’s actually a type of low blood pressure called orthostatic or postural hypotension, and according to the Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/orthostatic-hypotension/symptoms-causes/syc-20352548 it can cause dizziness, lightheadedness, and possibly fainting—each of which cause falls.While occasional dizziness is a minor problem, more frequent symptoms—or loss of consciousness, even for a few seconds—is more serious and can indicate a host of potential heart, glandular, or nervous system problems; as well as medication complications, exposure to heat, prolonged bed rest, alcohol consumption, and either malnutrition OR increased blood pressure after eating, which is called postprandial hypotension. This last condition is “more common” in seniors, according to the Mayo Clinic. These many possible causes mean it’s vital to diagnose the source of postural hypotension before finding treatment options.SolutionsThe good news is, there are established treatments processes that can mitigate or eliminate most of these balance-related problems.For sarcopenia and other muscle loss, doctors agree that some degree of muscle loss can be “reverted,” with muscle mass regained to some degree even in very old or frail people. Even slowing the progress of sarcopenia can make a huge difference in the quality of life of an older person, and the solutions are simple and relatively low in cost, according to the Cleveland Clinic article: make healthy food choices, remain physically active, and get routine physicals.Including 20 to 35 grams of high-quality protein in each meal will go a long way towards helping maintain muscle mass. At meals, aim to consume 30 to 35 grams of protein. Foods that fit this brief https://glacialridge.org/what-does-30-35-grams-of-protein-look-like/ include 4-5 ounces of meat, or about the size of a deck of playing cards; 1 1/2 cups of low-fat cottage cheese or Greek yogurt; 1/1/2 cup cooked lentils or beans; a cup of cooked oatmeal with a couple of tablespoons of peanut butter and flax seed stirred in; or half a cup of peanuts.Exercise, ideally including resistance training, is vital to maintaining muscle mass. This is not as hard to achieve as it may sound; you don’t have to join a gym or buy a lot of expensive equipment. Walking and climbing stairs—make sure you have good shoes, a sturdy rail to hold onto, and obstruction-free stair treads—builds muscle, keeps your joints and tendons flexible, and prevents bone loss, according to the National Institute on Aging. In addition, balance training like yoga and tai chi—easily available for free online—will help improve strength and balance, as will inexpensive resistance bands. Simple exercises like standing on one leg, “tightrope” walks in a straight line, and lunges https://www.webmd.com/healthy-aging/best-balance-exercises-for-seniors can target the specific muscles you need to maintain balance or recover balance when you stumble.And, of course, make time to see a healthcare provider routinely, and talk with them about any health changes or challenges you are experiencing.Sensory challenges are almost all potentially treatable, with researchers developing exciting tests and techniques even for complex problems like loss of smell.But while some solutions require medical intervention, others can be part of your daily life, starting with protecting your vision. Seeing an eye doctor annually is an important step, as is maintaining a healthy diet. In addition, according to WebMD, https://www.webmd.com/healthy-aging/how-to-maintain-vision-as-you-age wearing sunglasses regularly protects your eyes from exposure to ultraviolet light, while refraining from or quitting smoking can protect you from age-related macular degeneration, cataracts, glaucoma, diabetic retinopathy, and dry eyes.There’s also good “take-home advice” regarding hearing, and first on that list is taking steps to protect your ears from loud noises, according to the NIA. This is vital because “the delicate cells in our inner ear that encode sound do not regenerate over time like skin, heart, or liver cells.” Apps like hearingnumber.org (Sarah, leave this link as is rather than embedding it) help people measure their hearing with a smartphone. This is a great tool to keep track of your own hearing, as is seeing a doctor for semi-regular hearing screenings. If you are diagnosed with hearing loss, there are many excellent and ever-evolving products available to help you treat it.The picture is less clear for loss of smell; it is the most complex problem to solve and, as stated above, the most directly associated with the brain. Indeed, according to the NIA, the “olfactory bulb region” includes rounded masses of brain tissue above each nasal cavity; these masses not only house nerve cells involved in smell, but also part of a “circuit of neurons” involved in memory. For this reason, loss of smell can be a “canary in a coal mine” when it comes to diagnosing Alzheimer’s and other forms of dementia.But there are many other reasons that people might experience loss of smell, making it very important to see a medical provider to get some answers if it happens to you.And when it comes to the overall issue of balance and aging, it’s important to not just do what you can for your body, but to make sure your home environment is as safe as possible. We’ll be writing more about that soon, but in the meantime, if you have questions about ways to improve your home environment to help you age in place, we at Evolve have a wealth of expertise and a nationwide contractor network that could help you get the changes you need. Just let us know.
