References

Alcañiz M, Solé-Auró A Feeling good in old age: factors explaining health-related quality of life. Health Qual Life Outcomes. 2018; 16:(1) https://doi.org/10.1186/s12955-018-0877-z

Bartosch PS, Kristensson J, McGuigan FE, Akesson KE Frailty and prediction of recurrent falls over 10 years in a community cohort of 75-year-old women. Aging Clin Exp Res. 2020; 32:(11)2241-2250 https://doi.org/10.1007/s40520-019-01467-1

Bertrand K, Raymond MH, Miller WC, Martin Ginis KA, Demers L Walking aids for enabling activity and participation: a systematic review. Am J Phys Med Rehabil. 2017; 96:(12)894-903 https://doi.org/10.1097/PHM.0000000000000836

Bisdorff A, Bosser G, Gueguen R, Perrin P The epidemiology of vertigo, dizziness, and unsteadiness and its links to co-morbidities. Front Neurol. 2013; 4 https://doi.org/10.3389/fneur.2013.00029

Brännström J, Lövheim H, Gustafson Y, Nordström P Association between antidepressant drug use and hip fracture in older people before and after treatment initiation. JAMA Psychiatry. 2019; 76:(2)172-179 https://doi.org/10.1001/jamapsychiatry.2018.3679.

Buttigieg SC, Ilinca S, de Sao Jose JM, Larsson AT Researching ageism in health-care and long term care. In: Ayalon L, Tesch-Römer C Cham: Springer; 2018 https://doi.org/10.1007/978-3-319-73820-8_29

Canada B, Stephan Y, Sutin AR, Terracciano A Personality and falls among older adults: evidence from a longitudinal cohort. J Gerontol B Psychol Sci Soc Sci. 2020; 75:(9)1905-1910 https://doi.org/10.1093/geronb/gbz040

Cho BY, Seo DC, Lin HC, Lohrmann DK, Chomistek AK BMI and central obesity with falls among community-dwelling older adults. Am J Prev Med. 2018; 54:(4)e59-e66 https://doi.org/10.1016/j.amepre.2017.12.020

Delgado J, Jones L, Bradley MC Potentially inappropriate prescribing in dementia, multi-morbidity and incidence of adverse health outcomes. Age Ageing. 2021; 50:(2)457-464 https://doi.org/10.1093/ageing/afaa147

Dodig S, Čepelak I, Pavić I Hallmarks of senescence and aging. Biochem Med (Zagreb). 2019; 29:(3) https://doi.org/10.11613/BM.2019.030501

Donaldson PJ, Grey AC, Maceo Heilman B, Lim JC, Vaghefi E The physiological optics of the lens. Prog Retin Eye Res. 2017; 56:e1-e24 https://doi.org/10.1016/j.preteyeres.2016.09.002

Faragher RG, McArdle A, Willows A, Ostler EL Senescence in the aging process. F1000Res. 2017; 6 https://doi.org/10.12688/f1000research.10903.1

Foccillo G The infections causing acute respiratory failure in elderly patients. In: Esquinas A, Vargas N Cham: Springer; 2020 https://doi.org/10.1007/978-3-030-26664-6_5

Gazibara T, Kurtagic I, Kisic-Tepavcevic D, Nurkovic S, Kovacevic N, Gazibara T, Pekmezovic T Falls, risk factors and fear of falling among persons older than 65 years of age. Psychogeriatrics. 2017; 17:(4)215-223 https://doi.org/10.1111/psyg.12217

Kang Y, Ding H, Zhou H Epidemiology of worldwide spinal cord injury: a literature review. J Neurorestoratol. 2018; 6:(1) https://doi.org/10.2147/JN.S143236

Katsuumi G, Shimizu I, Yoshida Y, Minamino T Vascular senescence in cardiovascular and metabolic diseases. Front Cardiovasc Med. 2018; 5 https://doi.org/10.3389/fcvm.2018.00018

Kim J, Parish AL Polypharmacy and medication management in older adults. Nurs Clin North Am. 2017; 52:(3)457-468 https://doi.org/10.1016/j.cnur.2017.04.007

Kingston A, Robinson L, Booth H, Knapp M, Jagger C Projections of multi-morbidity in the older population in England to 2035: estimates from the Population Ageing and Care Simulation (PACSim) model. Age Ageing. 2018; 47:(3)374-380 https://doi.org/10.1093/ageing/afx201

Lee H, Ailshire J Neighborhood and housing conditions and risk of falls. Innov Aging. 2020; 4:(Suppl 1)651-652 https://doi.org/10.1093/geroni/igaa057.2245

Liu H, Yang Y, Xia Y Aging of cerebral white matter. Ageing Res Rev. 2017; 34:64-76 https://doi.org/10.1016/j.arr.2016.11.006

Maitre J, Jully JL, Gasnier Y, Paillard T Chronic physical activity preserves efficiency of proprioception in postural control in older women. J Rehabil Res Dev. 2013; 50:(6)811-820 https://doi.org/10.1682/JRRD.2012.08.0141

Meyer M, Constancias F, Vogel T, Kaltenbach G, Schmitt E Gait disorder among elderly people, psychomotor disadaptation syndrome: post-fall syndrome, risk factors and follow-up—a cohort study of 70 patients. Gerontology. 2021; 67:(1)17-24 https://doi.org/10.1159/000511356

Mielenz TJ, Kannoth S, Jia H Evaluating a two-level vs three-level fall risk screening algorithm for predicting falls among older adults. Front Public Health. 2020; 8 https://doi.org/10.3389/fpubh.2020.00373

Mordi JA, Ciuffreda KJ Static aspects of accommodation: age and presbyopia. Vision Res. 1998; 38:(11)1643-1653 https://doi.org/10.1016/S0042-6989(97)00336-2

Moreland B, Kakara R, Henry A Trends in nonfatal falls and fall-related injuries among adults aged ≥65 years—United States, 2012–2018. MMWR Morb Mortal Wkly Rep. 2020; 69:(27)875-881 https://doi.org/10.15585/mmwr.mm6927a5

Muchna A, Najafi B, Wendel CS, Schwenk M, Armstrong DG, Mohler J Foot problems in older adults associations with incident falls, frailty syndrome, and sensor-derived gait, balance, and physical activity measures. J Am Podiatr Med Assoc. 2018; 108:(2)126-139 https://doi.org/10.7547/15-186

Padrón-Monedero A, Pastor-Barriuso R, García López FJ, Martínez Martín P, Damián J Falls and long-term survival among older adults residing in care homes. PLoS One. 2020; 15:(5) https://doi.org/10.1371/journal.pone.0231618

Rice JB, White AG, Scarpati LM, Wan G, Nelson WW Long-term systemic corticosteroid exposure: a systematic literature review. Clin Ther. 2017; 39:(11)2216-2229 https://doi.org/10.1016/j.clinthera.2017.09.011

Rubiño JA, Gamundí A, Akaarir M, Canellas F, Rial R, Nicolau MC Bright light therapy and circadian cycles in institutionalized elders. Front Neurosci. 2020; 14 https://doi.org/10.3389/fnins.2020.00359

Saftari LN, Kwon OS Ageing vision and falls: a review. J Physiol Anthropol. 2018; 37:(1) https://doi.org/10.1186/s40101-018-0170-1

Sengoku R Aging and Alzheimer's disease pathology. Neuropathology. 2020; 40:(1)22-29 https://doi.org/10.1111/neup.12626

Sharma P, Sharma A, Fayaz F, Wakode S, Pottoo FH Biological signatures of Alzheimer's disease. Curr Top Med Chem. 2020; 20:(9)770-781 https://doi.org/10.2174/1568026620666200228095553

Tieland M, Trouwborst I, Clark BC Skeletal muscle performance and ageing. J Cachexia Sarcopenia Muscle. 2018; 9:(1)3-19 https://doi.org/10.1002/jcsm.12238

Toots A, Wiklund R, Littbrand H The effects of exercise on falls in older people with dementia living in nursing homes: a randomized controlled trial. J Am Med Dir Assoc. 2019; 20:(7)835-842.e1 https://doi.org/10.1016/j.jamda.2018.10.009

Tornero-Quiñones I, Sáez-Padilla J, Espina Díaz A, Abad Robles MT, Sierra Robles Á Functional ability, frailty and risk of falls in the elderly: relations with autonomy in daily living. Int J Environ Res Public Health. 2020; 17:(3) https://doi.org/10.3390/ijerph17031006

Ungvari Z, Tarantini S, Donato AJ, Galvan V, Csiszar A Mechanisms of vascular aging. Circ Res. 2018; 123:(7)849-867 https://doi.org/10.1161/CIRCRESAHA.118.311378

van den Anker J, Reed MD, Allegaert K, Kearns GL Developmental changes in pharmacokinetics and pharmacodynamics. J Clin Pharmacol. 2018; 58:(Suppl 10)S10-S25 https://doi.org/10.1002/jcph.1284

van Onna M, Boonen A The challenging interplay between rheumatoid arthritis, ageing and comorbidities. BMC Musculoskelet Disord. 2016; 17 https://doi.org/10.1186/s12891-016-1038-3

Veronese N, Stubbs B, Noale M Polypharmacy is associated with higher frailty risk in older people: an 8-year longitudinal cohort study. J Am Med Dir Assoc. 2017; 18:(7)624-628 https://doi.org/10.1016/j.jamda.2017.02.009

Wang Y, Huang H, Chen G Effects of lighting on ECG, visual performance and psychology of the elderly. Optik. 2020; 203 https://doi.org/10.1016/j.ijleo.2019.164063

Wolffsohn JS, Davies LN Presbyopia: effectiveness of correction strategies. Prog Retin Eye Res. 2019; 68:124-143 https://doi.org/10.1016/j.preteyeres.2018.09.004

clinical practice

Falls in older people

02 May 2022
Features
02 May 2022
Volume 14 · Issue 5

Abstract

Paramedic programmes incorporate person-centred approaches to the individualisation of emergency care. Within this context, older patients (aged 65+) pose specific challenges in relation to their ambulatory health and wellbeing. Helping these patients to avoid falling can contribute significantly to reducing their morbidity and mortality and improving their overall health and wellbeing. Alongside this, in times of economic constraint, it is the responsibility of all health professionals to promote ambulatory wellbeing to address the inordinate number of people necessitating paramedic support and intervention because of falls each year in the UK. Understanding the underlying processes of ageing, which are often a mix of the normal processes of physiological senescence, plus the impact of pathology—which is not age specific but occurs more commonly in older people—enables practitioners to build knowledge of how best these people can be supported. This short module affords paramedics the opportunity to learn about these physiological processes and to look at the holistic impact that falls can have on older people.

After completing this module, the paramedic will be able to:

With higher numbers of older adults living beyond the age of 65 years, there is a corresponding rise in falls in the home, which are the commonest cause of injuries sustained in people in this age group (Moreland et al, 2020).

Emergency paramedic services are often called to clinically assess and manage the immediate care of people at the site of their injury then transport them into accident and emergency services.

Statistical analysis reveals that the risk of falls increases significantly with age, which can lead to potentially long-term issues and problems with maintaining ambulatory wellbeing. Resultant physical disability or impairment also contributes to poorer outcomes in quality and longevity of life (Tornero-Quiñones et al, 2020). Fatalities because of falls in those aged over 65 years account for up to one-third of all accidental deaths in this age group (Mielenz et al, 2020).

Subscribe to get full access to the Journal of Paramedic Practice

Thank you for visiting the Journal of Paramedic Practice and reading our archive of expert clinical content. If you would like to read more from the only journal dedicated to those working in emergency care, you can start your subscription today for just £48.

What's included

  • CPD Focus

  • Develop your career

  • Stay informed

Register
Or continue by

Signing in with your registered email address