Falling Is Taking a Toll on Elderly Brains

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April 06, 2017 | 31,898 views

Story at-a-glance

  • Among U.S. adults aged 75 and older, 1 in 45 suffered from a brain injury that led to an emergency room visit, hospitalization or death in 2013
  • This is a 76 percent increase from 2007 — with the primary cause being falls
  • Regular exercise, protecting your vision health and removing home hazards can significantly reduce your risk of falls

By Dr. Mercola

Falls are a leading cause of injury among Americans aged 65 and over, with 1 in 5 leading to a serious injury such as a broken bone or head injury. More than 1 in 4 older Americans falls every year, and such falls are the most common cause of traumatic brain injuries (TBI) among this population.1

In March 2017, the U.S. Centers for Disease Control and Prevention (CDC) released a report with some startling figures regarding TBI in older Americans, including those related to falls.

Among those 75 and older, 1 in 45 suffered from a brain injury that led to an emergency room visit, hospitalization or death in 2013 — a 76 percent increase from 2007 — with the primary cause being falls.2

While brain injuries due to motor-vehicle accidents decreased during the study period, and considerable attention has been given to concussions in youth as a result of sports, far less attention has been given to the risk of brain injury in older Americans due to falls. The authors noted:3

"[F]rom 2007 to 2013 … the number and rate of older adult fall-related TBIs have increased substantially … the findings in this report suggest that TBIs attributable to older adult falls, many of which result in hospitalization and death, should receive public health attention."

'Urgent Need' for Fall Prevention Efforts

The CDC cited an urgent need to increase fall prevention efforts in older adults, given the concerning increase in fall-related brain injuries. Adding to the risk, once a person has fallen, their likelihood of falling again doubles.4 Risk factors that increase a person's risk of falling include:5

Lower body weakness

Vitamin D deficiency

Difficulties with balance and walking

Use of certain medications, such as tranquilizers, sedatives or antidepressants

Vision problems

Foot pain or poor footwear

Hazards in the home, such as clutter, throw rugs or uneven steps

Health conditions, including Parkinson's disease, Alzheimer's disease and arthritis, as well as recent surgery, such as hip replacement

Lack of Physical Activity Increases Fall Risk

One of the many reasons why exercise is so important for older adults is that doing so can significantly lower your risk of falls and all of the health risks that go along with them. Not only that, but if you do fall, if you're a regular exerciser you're less likely to get hurt.

Older adults who took part in an exercise program were 37 percent less likely to be injured during a fall compared to non-exercisers, according to research published in the BMJ.6

This included a 61 percent lower risk of having a fall-induced broken bone and 43 percent lower risk of sustaining a fall-related injury serious enough to require admission to a hospital.

The exercises included an emphasis on balance training along with strength and functional training and even Tai Chi. As you get older, your muscle and bone mass decrease and the senses that guide your balance — vision, touch, proprioception — may all start to deteriorate, and this can make you unsteady on your feet.

However, eight weeks of balance training reduced slips and improved the likelihood of recovery from slips among the elderly.7 Balance training has also been found effective in improving functional and static balance, mobility and falling frequency in elderly women with osteoporosis.8

Since exercise strengthens both your body and your mind, it's likely that regular exercisers are not only physically more able to prevent falls but also may be quicker mentally, perhaps allowing them to reach out and grab a railing for support before succumbing to a fall.

Easy Strength Training Exercises to Reduce Your Fall Risk

Strength training is also important for older adults, as it helps you maintain healthy bone mass, prevent age-related muscle loss and strengthens your connective tissues, tendons and ligaments, which help hold your body in the upright position.

Strength training also helps with functional movements — the ones you do every day — which will make activities like climbing stairs and getting out of a chair easier. This, in turn, will lower your risk of falls. Even if you're new to exercise, there are options that can lower your fall risk, including the two that follow.

Knee Extension

Knee extension exercises will help strengthen your knees, which will improve your balance and reduce your risk of falling. Strengthening your knees will also allow you to walk and climb stairs with greater ease and comfort.

  1. Sit on a chair with your back straight and knees bent
  2. Slowly extend your right leg out in front of you and hold for a few seconds before lowering it back to starting position
  3. Repeat with your left leg
  4. Do 10 repetitions on each leg

For a more advanced version, strap an ankle weight around each ankle. Aim for a weight that is heavy enough to where you cannot do more than 15 repetitions per leg. As you get stronger, you can add more weight to keep it challenging.

Partial Squat

Squatting exercises increase hip flexibility and strengthen your hip flexors and quadriceps, which will improve both your walking ability and your ability to stand up from a seated position. They also improve your overall balance and stability, reducing your risk of falling.

For the beginner's version, stand up using a chair for support, and perform a standing partial squat as demonstrated in the ElderGym video above. Remember to push your buttocks out as you bend to maintain a straight back posture and do not bend your knees past your toes.

Take Care of Your Vison Health

Being able to see clearly is important to avoid tripping hazards and avoid dizziness. Your diet is key to protecting your vision, including eating plenty of vitamin-C-rich foods, which may lower your risk of cataracts.9 Bioflavonoids, which may have a complementary effect when consumed along with vitamin C, are also important.

Excellent dietary sources of bioflavonoids include dark-colored berries, dark leafy greens, garlic and onions. Other notable nutrients for vision health include:

Astaxanthin

Animal-based omega-3 fat (found in wild-caught Alaskan salmon).

Anthocyanins (found in blueberries, bilberries, and black currants)

Vitamin D

Lutein and zeaxanthin (found in green leafy vegetables and pastured egg yolks)

Bioflavonoids (found in tea, cherries, and citrus fruits)

Besides eating plenty of the nutrients above, carotenoid-rich vegetables, organic pastured egg yolks, omega-3 and astaxanthin-rich wild-caught salmon are beneficial for vision health. Another important dietary aspect is to normalize your blood sugar, as excessive sugar in your blood can pull fluid from the lens of your eye, affecting your ability to focus.

It can also damage the blood vessels in your retina, thereby obstructing blood flow. To keep your blood sugar in a healthy range, follow my comprehensive nutrition guidelines, including avoiding processed foods, as they tend to be loaded with processed fructose. Exercise will also help protect your vision.

Block Blue Light to Protect Your Vision, Especially at Night

Many people are unaware of the importance of avoiding exposure to blue light after sundown, including from light-emitting diode (LED) lighting and electronics. Near-infrared light is important as it primes the cells in your retina for repair and regeneration, which explains why LEDs — which are devoid of infrared — are so harmful for your eyes.

There are cells in your retina that are responsible for producing melatonin in order to regenerate your retina during the night. If you use LED lights after sunset, however, you reduce the regenerative and restoring capacities of your eyes and with less regeneration you end up with degeneration.

In this case, the degeneration can lead to age-related macular degeneration (AMD), which is the primary cause of blindness among the elderly and can also contribute to falls.

So, to summarize, the main problem with LEDs is the fact that they emit primarily blue wavelengths and lack the counterbalancing healing and regenerative near-infrared frequencies. They have very little red in them, and no infrared, which is the wavelength required for repair and regeneration.

Because of this, I strongly recommend using blue-blocking glasses after sundown and swapping out your LEDs for clear bulb incandescents or even candle light. For your computer, reduce the correlated color temperature down to 2,700 K — even during the day, not just at night. Many use f.lux to do this, but I also like the software Iris for this purpose.

How to Make Your Home Safer to Avoid Falls

Home hazards can be a significant contributor to falls, as it's estimated that one-third of falls in the elderly may be due to environmental hazards that could easily be addressed.10 Aging Care compiled a comprehensive list of tips to make your home safer in order to prevent falls.11

Install safety bars and grab bars where necessary, such as in the shower/bath and near toilets

Stairwells should be well lit, with sturdy railings that extend beyond the first and last steps

Remove loose throw rugs and tack down all carpeting/rugs

Put anti-slip mats into the bottom of the bathtub or consider a shower chair

Use a stool riser seat when using the toilet

Remove clutter from the home

Adjust electrical cords so they are not stretched across the floor

Wear shoes or slippers with non-slip soles

Keep items used daily in easily accessible locations

Avoid the use of chairs or stepladders to reach item; use a grasping tool instead

Install adequate lighting in the home

In addition, fall mats, which are cushioned surfaces that help reduce injuries in the event of a fall, can be placed in frequented areas, such as next to a bed, chair or toilet. Some people may find added support from the use of a cane or walker, but be aware that some research has linked the use of walking aids to an increased risk of falls.12

It's important to understand that falls are not inevitable and oftentimes are preventable. By making sensible changes to your home, eating right, exercising and taking care of your vision health, you can significantly lower your risk of suffering from a debilitating fall and related brain injury.

[+]Sources and References [-]Sources and References

  • 1, 4, 5 U.S. CDC, Important Facts About Falls
  • 2 STAT News March 16, 2017
  • 3 Surveillance Summaries / March 17, 2017 / 66(9);1–16
  • 6 BMJ October 29, 2013
  • 7 International Journal of Rehabilitation Research: March 2010 - Volume 33 - Issue 1 - pp 49-55
  • 8 Osteoporos Int. 2007 April; 18(4): 419–425.
  • 9 Ophthalmology March 23, 2016
  • 10, 11 Aging Care, 6 Things That Cause the Elderly to Fall
  • 12 Journal of Clinical Gerontology and Geriatrics September 2016, Volume 7, Issue 3, Pages 99-103