Risk of falls in the elderly

By usmlevideoss

A 65 year-old female arrives in your office for her annual health checkup. Which of the following is true about the risk of falls in the elderly? 

  1. in most older individuals, men fall more often than women 
  2. in most older individuals, whites fall more often than Africans 
  3. the risk of falls is raised significantly in elderly individuals who take four or more medications 
  4. Living alone does not appear to be a risk factor in falls 
  5. Vitamin D deficiency is not associated with increased risk of falls 

Correct Answer is C. Falls are a serious problem in older adults, increasing morbidity and mortality. Polypharmacy is a risk factor for falls with psychotropic medications taking the top of the list. Benzodiazepines (drowsiness, confusion, syncope, tremors), sedatives (excessive sedation), antipsychotics (postural hypotension, sedation, muscle rigidity), cholinesterase inhibitors (bradycardia), antidepressants (postural hypotension), antihypertensives (bradycardia, hypotension), diuretics (hypovolemia), hypoglycemics (acute hypoglycemia) – combination of these drug types place older patients at increased risk of falling. Physicians should take time to go over the list of current medications in each patient visit and try to reduce the dose or eliminate these medications if possible. 

Incorrect Answers: 

  1. In most older individuals, women fall more often than men
  2. Studies show that Whites fall more often than Africans, Caribbeans, Hispanics, and South Asians.

D. Living alone appears to be a risk factor in falls.

E. Vitamin D deficiency can result in muscle weakness, osteoporosis, and impaired gait patterns, resulting in increased risk of falls. For community-dwelling or long term care residents, vitamin D supplementation in doses from 700 IU/d to 1000 IU/d can reduce falls by 19% after 2-5 months of starting treatment. 

https://www.ncbi.nlm.nih.gov/books/NBK560761/