RxPG News : Falls

Avoid Falls!

Fri, 12 Aug 2005 00:25:38 PST

( from http://www.rxpgnews.com ) Whether it is caused by a wet floor, slippery throw rug, loose cord or objects in the wrong spot, falls in the home happen. The truth is, falls are not only the most common cause of injury among American adults age 65 and over, but are also the leading cause of death in the home, according to the National Safety Council. One in three adults over age 65 falls every year, and 90 percent of the 350,000 hip fractures that occur in the U.S. each year are the result of a fall. According to the American Academy of Orthopaedic Surgeons (AAOS), fall-related injuries can be reduced by removing clutter and items from the home, learning how to fall properly, and performing exercises that strengthen muscles and improve balance.

"It can take just one fall to lead to the loss of a person's independence and mobility," explained Richard F. Kyle, MD, first vice president of AAOS. "It is important to minimize obstacles in the home that often contribute to slips and falls. When simple safety measures are put in place, these mishaps can decrease significantly."

AAOS recommends following the below home safety checklist to fall-proof your home:

-- Get rid of clutter. Don't pile up items on the floor, stairway or pathways between rooms.

-- Keep appliance, lamp and telephone cords out of areas where you walk. Don't put them under rugs.

-- Use a rubber mat or put adhesive texture strips on the bottom of the tub or shower. Install grab bars on the walls for additional support. Place a slip-resistant rug on tile floor to safely get in and out of the bathtub.

-- Attach non-slip treads to bare-wood steps, and remove small area rugs at the top and bottom of stairs.

-- Good lighting is essential, so it is important to install glow-in-the-dark light switches at both the top and bottom of stairways. Also, place a night-light along the route between the bedroom and bathroom.

-- Keep a flashlight and new batteries by the bed in case of a power outage.

-- Clean up spills in the kitchen immediately. Use a step stool or low stepladder -- not chairs or boxes -- to reach items in upper cabinets. Use non-skid wax on the kitchen floor.

-- Wear proper footwear around the home and outside. Never walk around in stocking feet. Consider sneakers and shoes with laces. Avoid higher heels or platform shoes.

Of course, even the most careful people are still susceptible to trips and falls. With that in mind, there are "correct" ways to fall to minimize potential injury. Below are some recommended techniques to follow if you cannot prevent a slip or fall:

-- If possible, try to fall on your side or buttocks. Roll over naturally, turning your head in the direction of the roll.

-- Keep your wrists, elbows and knees bent. Do not try to break the fall with your hands or elbows.

-- Take several deep breaths after falling. If you feel you have suffered an injury, do not try to get up. Call 911 or a family member for help.

-- If you feel you are not injured and are able to get up, crawl to a strong, stable piece of furniture, like a chair, that you can use as a support to help pull yourself up. Place both hands on the seat.

-- Slowly begin to raise yourself up. Bend whichever knee is stronger, keeping the other knee on the floor. Finally, slowly twist and sit in the chair.

The Academy recommends that everyone, especially seniors, get regular physical check-ups. A healthcare provider may discover problems that can make someone more prone to falling. A provider can also monitor side effects from any prescriptions and over-the-counter medications, such as sleep aids, that might affect balance. People of all ages can reduce their risk of falls through regular exercise, as even moderate physical activity can help maintain strength, coordination, agility and balance. Exercises that improve balance and coordination are the most beneficial. A sedentary lifestyle -- at any age -- leads to weakness and increased chances of falling.

Genes may ultimately dictate seniors' mobility

Wed, 10 Aug 2005 00:27:38 PST

( from http://www.rxpgnews.com ) Genes can keep elderly people from benefiting equally from exercise, no matter how much effort they expend, according to research findings published in today's (Aug. 10) Journal of the American Medical Association.

Of nearly 3,000 seniors studied, those who exercised stayed healthier than their couch potato peers, but those born with a certain gene benefited the most from physical activity, said Marco Pahor, M.D., director of University of Florida's Institute on Aging and the multi-institutional study's senior author.

"To our knowledge, this is the first study to show behavioral and genetic interaction in functioning and aging, and shows people are already pre-selected, that there are genes that interact with behavior to affect mobility," Pahor said.

Decreasing mobility, along with lack of muscle strength and a decline in aerobic ability, are common aspects of aging that can lead to loss in quality of life, Pahor said. Understanding the mechanisms of how people lose mobility may lead to ways to help people remain independent longer, he added.

Federal health statistics have shown that about 34 percent of the U.S. population aged 70 or older reports difficulty walking a quarter of a mile. These individuals are at much greater risk of moving into a nursing home or dying over a two-year period, compared with their counterparts who do not report trouble walking the distance.

And despite the undisputed benefits of exercise, not everyone responds the same, even when they do lead active lives - for reasons that have not been entirely clear.

In the current study, researchers assessed seniors in an effort to better understand the relationship between genetic makeup, intensity of physical activity and functional decline. Twice a year throughout the four-year study, participants ages 70 to 79 reported their level of activity and their ability to walk a quarter mile or up 10 stairs.

Researchers also tested the blood of each study subject to identify which version of a gene long associated with exercise performance they had. About a third of the population possesses the DD genotype of the gene, named for the angiotensin-converting enzyme, or ACE. The rest have the II or ID versions of the ACE gene.

Study participants were categorized according to their exercise intensity and their genetic makeup. Overall, about 41 percent of study participants became less mobile over the four-year period. Even though people who exercised were less likely to develop substantial physical limitations, not everyone received the same benefits, even if they exercised with the same intensity.

About a third of the seniors engaged in significant physical exercise including walking and strenuous exercise, and they preserved their mobility longer than the 70 percent who engaged in little or no physical activity. Researchers also evaluated the 8 percent who reported participating in weight training.

But genetic makeup influenced long-term physical function. Among exercisers, the DD and ID genotypes were more likely to remain fit than those with the II genotype, who developed mobility problems at a 45 percent higher rate, researchers found. No difference in mobility according to genotype was found among non-exercisers, suggesting function was influenced by an interaction between exercise intensity and genetic make-up.

In addition, seniors who reported weight training and had the DD or ID genotype displayed the lowest rate of mobility loss in any exercise category. In contrast, weight trainers with the II genotype developed physical limitations similar to those experienced by seniors who were relatively inactive.

What differences in body composition the genotype creates also may yield clues to what causes mobility limitations to develop with age, and what people can do to stay active, Pahor said. Those with the II genotype, for example, tended to have higher total body fat.

"The good news is that regardless of genotype, the physically active people were at lower risk of losing mobility, suggesting that everyone should exercise to preserve mobility," said Pahor, a professor and chairman of the College of Medicine's department of aging and geriatric research.

The study's lead author, Stephen Kritchevsky, Ph.D., a professor and director of the Sticht Center on Aging at the Wake Forest University School of Medicine, said that people respond differently to exercise and that the implications of that response may change as they age.

"In our study, the II genotype is associated with increased fat in the leg muscles," Kritchevsky said. "Now energy storage near muscles may benefit young athletes engaged in endurance activities, but in older persons, accumulation of leg fat has been linked to poorer muscle function and metabolic diseases like diabetes."

The study, funded by the National Institute on Aging and the Claude D. Pepper Older Americans Independence Center and conducted in conjunction with researchers at several other institutions, including the University of Tennessee and the University of Pittsburgh, opens the door to more research on the interaction of behavior and genes and how that changes with age, Pahor said.

"This report is one step," he said. "It is necessary to do more research to determine whether there are other genes that may affect the benefits of physical activity on functioning of older adults."

Frequent falls?....Try Tai Chi

Tue, 28 Jun 2005 00:23:38 PST

( from http://www.rxpgnews.com ) Older people who took part in a structured programme of Tai Chi found that their balance and physical strength improved, reducing the risk of falls, according to a paper in the latest Journal of Advanced Nursing.
Researchers studied a group of fall-prone adults, with an average age of 78, living in residential care. 29 undertook a 12-week Tai Chi course three times a week and 30 formed the non-exercise control group.

They found that the physical fitness of the exercise group showed significant improvement, with stronger knee and ankle muscles, improved mobility and flexibility and better balance.

For example, after the exercise programme had finished, the time taken by the exercise group to walk six metres had fallen by 25 per cent, while the control group took 14 per cent longer.

"As people get older they are more likely to experience falls and this can lead to some very serious health issues" says co-author Professor Rhayun Song from the Chung Nam National University in South Korea.

"Figures published in the United States estimate that 30 per cent of people over 65 living in the community fall each year and this rises to up to 50 per cent for people in long-term care facilities, such as residential homes. One in ten falls results in a fracture.

"Regular exercise is very important as we get older because when we get to 65 we start losing muscle strength at a rate of up to two per cent per year."

Tai Chi, an ancient Chinese martial art consisting of a series of slow, gentle, continuous movements, is particularly suitable for older people as it helps them to develop stronger muscles and better balance and concentration.

The exercise programme used in the research consisted of 10 minutes of warming up exercises, 20 minutes of Sun-style Tai Chi movement and five minutes of cooling down exercises. Traditional instrumental music was used to help the group maintain slow and continuous movements and provide a soothing effect.

Both groups underwent a series of tests before the 12-week exercise programme and once it had been completed. This measured their muscle strength, balance and confidence in avoiding falls.

Participants were also asked to report any falls they experienced during the test period. 31 per cent of the exercise group said they had had a fall, compared with 50 per cent of the control group.

In the year before the research started, 66 per cent of the exercise group had reported a fall, together with 57 per cent of the control group.

"Our study shows that low-intensity exercise such as Tai Chi has great potential for health promotion as it can help older people to avoid falls by developing their balance, muscle strength and confidence" says Professor Song.

"We believe that regular exercise should be a fundamental part of caring for older people living in the community and in residential care."