You’ve probably heard it before: Aging ain’t for sissies.
It is not a time for passivity either if you want to age gracefully and retain quality of life throughout the years. There are hidden risks associated with aging, risks that threaten our physical and emotional health, and can have dire consequences for quality of life and independence.
As we get older, many things change that are largely outside of our control. There are changes to our appearance. Changes to our stamina. Changes to our health. Most changes are well-known and can be anticipated in advance. We are seldom surprised to notice gray hair, wrinkles or changes to our vision, hearing or memory.
One would think that with the growing older adult population we would know all there is to know about getting older, and all the risks associated with it. Unfortunately, there are hidden risks that public health campaigns have not yet begun to address.
Are you at risk?
Every successful business conducts risk assessments to identify and minimize potential risks. In our personal lives, we conduct informal risk assessments when we make major purchases, at different times during parenting, and while driving a car or riding a bicycle.
Personal Risk Assessment
The following is a quick risk assessment. There are four sections. Simply put a check next to each item that applies to you, or a loved one, below:
Section 1. Age
__ 55-64 years old
__ 65-75 years old
__ 75 years or old
Section 2. Chronic health conditions
__ Heart disease
__ Pulmonary disease
__ Other chronic disease/health conditions (write the number of other diseases/conditions
that you have on the line)
__ Total (add up the number of total health issues)
Section 3. Medications.
__ Three or more medications
__ Psychotropic medications
__ Anti-arrhythmic heart medications
Section 4. Other factors (e.g., physical, neurological).
__ Weak leg muscles
__ Unsteady gait
__ Poor vision
__ Hearing loss
__ Memory loss
__ History of falls (two or more falls within a six-month period)
(The above are research-based identified risk factors. See Rubenstein & Josephson (2003) Risk Factors for Falls: A Central Role in Prevention.)
As you might expect, aging-related risks increase with age. The above assessment identifies your risk for experiencing a fall. Falling among older adults has reached epidemic proportions.
Dr. Laurence Rubenstein, M.D., professor of geriatric medicine at University of California, Los Angeles, states that 40 percent of people ages 65 and older, living at home, will fall at least once each year and approximately one in 40 will be hospitalized as a result of the fall. Only about 50 percent of those hospitalized will still be alive a year later.
In 2010, fatalities in California as a result of a fall for those ages 65 and over exceeded the number of fatalities due to motor vehicle accidents, bicycle accidents and pedestrian accidents combined, and include all age groups (State of California EpiCenter). A little closer to home, nearly 15,000 older adults were seen in Solano County emergency departments for fall-related injuries between 2006 and 2011. During that same period, 3,547 older adults were hospitalized due to injuries sustained in a fall.
Age-related factors: The rate of falls increases with age. People 75 years and older are about twice as likely to fall and sustain serious injury. The physical changes that precipitate fall risks, such as diminished strength, begin before you turn 65. It is imperative that you take precautions to maintain your strength and health as you age if you want to prevent falls and injuries.
Chronic health conditions: Most falls among older adults have multiple interacting, synergistic factors that require complex clinical analysis. If you have fallen or are at high risk of falling, it is essential that you discuss the issues with your doctor.
Medications: Research has shown that three or more medications and certain types of medications, such as psychotropics, anti-arrhythmia heart medications and diuretics, can increase the risk of falls (Rubenstein & Josephson, 2003). Ask your doctor to assess your medications for risk.
Other factors: Myriad factors contribute to one’s risk of falling. Weakness in the lower extremities pose the greatest risk, increasing the odds of falling by four times. Weakness in the lower extremities is often the result of limited physical activity. With your doctor’s approval, an exercise program that includes strength building can greatly improve this problem and reduce your risk. Visual impairments increase your risk of falling by 2.5 times. Most causes of visual impairments are medically treatable.
Twenty to 50 percent of people over the age of 65 experience gait and balance problems. Use of assistive devices, such as a walker or cane, help prevent falling. Walking sticks are becoming a trendy way to add support.
Cognitive deficits and depression are associated with a two-fold increase in the risk of falling. Other issues such as hearing loss, dizziness and confusion are also associated with a higher risk.
Be proactive. Falls are devastating to health, independence and quality of life.
Identifying and eliminating environmental risks in homes or institutions could prevent many falls due primarily to environmental causes, and adequate medical evaluation and treatment for underlying medical risk factors, such as unstable gait and disabling medical conditions, could prevent many medically related falls.
Rochelle Sherlock, M.A., is a consultant with the Senior Coalition of Solano County, an advisory board to Solano County’s Board of Supervisors.