March 27, 2017

Falls and the Elderly and Me

My recent fall -- which fractured my hip and led to hip replacement surgery -- has become a major concern. Most of us have heard stories like this: an elderly person falls and breaks something -- a hip, a wrist, an arm. As a result, a once healthy, independent senior begins an inexorable downhill slide.

The statistics support my concern. Falls are the leading cause of injury-related death, and the third leading cause of poor health among persons aged 65 and older.

Nearly a third of older people experience functional decline after a fall, and many confront psychological difficulties directly related to the fall. Among these psychological consequences are fear of falling, activity avoidance, and loss of self-confidence. Together, these consequences have been labeled "post-fall syndrome."

Not surprisingly, seniors susceptible to falls also face higher rates of hospitalization and institutionalization. Hospital stays are almost twice as long in elderly patients who were admitted because they fell. Those same patients are at greater risk for subsequent institutionalization.

One in four elderly people who sustain a hip fracture die within six months of the injury. Over 50 percent of older patients who survive hip fractures are discharged to nursing homes, and nearly half of these patients are still there one year later. Hip fracture survivors experience a 10-15 percent decrease in life expectancy and a meaningful decline in overall quality of life.

Parkison's Disease and Falls
Those of us with Parkinson's disease (PD) are more likely to fall due to the changes in the brain caused by the disease. PD often causes walking and balance problems, tremors, and muscle rigidity.

Researchers have found that 25 percent of people recently diagnosed with PD suffer a fall in their first year with the disease. Other statistics show that -- among people who've lived with PD for at least 16 years -- over 70 percent experienced falls. People (like me) whose PD is not dominated by tremors often carry a higher risk of falling early in the progress of the disease.

If you've fallen once, you're more likely to fall again. Before my January fall, I'd seldom had a PD-related fall. In the six weeks I've been home from the hospital and rehab center, I've fallen twice, due to my own negligence.

While carbidopa-levodopa -- PD's gold-standard medication -- can suppress some of the PD symptoms, the risk of falling is not one of them.

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Having already depressed myself with this blog post, I might as well follow up with a report on how I'm dealing with this issue. Stay tuned.


Second Wind Boomer said...

I notice that you live in DC. I live in Alexandria and would love a neurologist recommendation if you would be so generous to share.

John Schappi said...

I've been using Dr. Herzfeld at the K St. office of the Neurology Center but I've been having a terrible time trying to get an appointment with her. said...

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