1. Falls and Mobility in Aging
Gait, balance & exercise programs
Environmental hazard modification
Cardiovascular disorder treatment
Intervention Options
Postural hypotension treatment
Medication modification
2 or more falls, 1 fall with injury
Cardiac eval if symptoms suggest syncope
Vitals-Orthostatics if indicated
Do Falls Assessment
Lower extremity strength
Targeted neuro exam
Timed Up & Go test
Visual assessment
Fall reported in last year
Brief Fall History
Chronic conditions
Circumstances
Medications
ETOH Intake
Mobility
Each year, thousands of Americans over the age of 65 fall
Falls and Mobility in Aging
with serious injury, fracture, or death.
Chang, T.T. and David A. Ganz. Quality Indicators for Falls and Mobility Problems in Vulnerable Elders. JAGS 55-S327-S334, 2007.
Reference
Supported by a grant from the DW Reynolds Foundation
ABNORMAL
Single fall with no injury
Perform Timed Up & Go test
Consider recommending exercise program
NORMAL

2. Falls and Mobility in Aging
*Refer to Ophthalmology
Orthostatic hypotension
(Abnormalities are found in 20-40% of age 65 and older
*Perform Timed Up and
10 feet < 10 seconds.
Decreased visual acuity
found on vision screen
muscle strengthening
*Review medication list
*Eliminate HIGH RISK
therapy for gait and
*Evaluate as indicated
if abnormalities are
Medication Review
*Reduce NUMBER of
medications when possible
and Home Safety
for possible causes
balance training,
2. Gait and Balance Evaluation
*Refer to physical
Go test (TUG)
medications
evaluation
*Psychoactive meds (eg. benzodiazepines, tricyclic antidepressants, sedatives)
*Antidepressants (SSRIs)
*Peripheral neuropathy
Orthostatic hypotension
Decreased visual acuity
High Risk Medications
*Anticonvulsants
Depressive symptoms
(Refer to Beer’s list)
Cognitive impairment
1. Use of more than 4
*Antiarrhythmics
*Anticholinergics
Gait and Balance
Abnormalities:
medications
*Parkinson’s
*Arthritis
include:
*CVA
Evaluation & Treatment
Falls and Mobility in Aging
Risk Factors
Restricted mobility due to injury and fear of falling (post fall anxiety syndrome)
Increased risk for death - (75% of the deaths due to falls occur in the 14% of the population age 65 and older)
Decreased activities of daily living (ADLs) – due to loss of self-confidence and self-imposed functional restrictions
Increased nursing home placement
Consequences