Every pill you take could spell disaster.
I'm not talking about possible overdoses or getting the wrong prescription (like my mother did)... I'm talking about increased fall risk for folks who take multiple meds.
We've seen the problem of too many pills before. Called "polypharmacy," it involves taking five or more prescription drugs at once. In one survey a few years ago from JAMA Internal Medicine, about 36% of folks 62 to 85 used five or more prescription drugs. But we suspect that number's much higher today...
And it's causing more issues than we previously knew. One of those is an increase in falls.
In fact, one in four Americans 65 and older will fall this year. And of those, about 800,000 will be hospitalized and more than 27,000 will die.
A new Canadian study published in the Journal of the American Geriatrics Society looked specifically at people's gaits – how they walk. The worse your gait is, the more likely you are to fall. Researchers found over a five-year period that the gaits of people taking five or more medications worsened much more than the gaits of those taking fewer medications. Most interesting, it seemed dose-dependent... For every additional medication someone took, their gait got worse by about 15% and their risk of falling increased 5%.
You might think that the folks who fall more have conditions that put them at risk, which could also be why they're on medications. But the researchers factored this into their analysis and only looked at people who didn't have neurological illnesses that could interfere with gait.
Polypharmacy causes many problems, including dangerous medication interactions, unwanted side effects, and problems with issues like dementia and falling. It's another reason we always suggest keeping a full list of every medicine you take (vitamins, supplements, and over-the-counter stuff included) and making sure every one of your doctors has a copy. If you feel you're taking too many, ask if there are any you can cut out.
In the meantime, we have a few other tips to prevent falls. They're common sense steps everyone should take as soon as possible...
Five Additional Tips to Stay Fall Free
1. Move more. Getting regular exercise, even just a simple walk every day, will help build muscle tone, strengthen your bones, and improve your balance. In fact, the best results come from doing a combination of balance and strength training exercises.
For balance, we recommend yoga and tai chi. I've written about yoga and its benefits for managing stress and improving balance (read it here). Tai chi focuses your breathing and takes you through a series of movements that you can do at your own pace. It keeps your body in motion and is safe for most people, including those 65 and older. It's also an effective stress-buster.
For strength, we recommend weight-bearing exercise. One study from American Family Physician introduced simple weight-bearing exercise to folks in various retirement villages. These simple exercises improved walking distance and resulted in an overall drop in number of falls compared with the control group.
2. Invest in good shoes. Well-fitting shoes with non-slip soles are a great investment. That's because shoes with slick soles contribute to falls, as does foot pain. Taking the time to find a good pair of comfortable shoes will not only help keep you safe, but will also help alleviate your pain. Stores like The Walking Company offer foot measurement and evaluations for a range of shoes designed for older folks as well.
3. Pick up after your pets. While pets provide affection and relief from loneliness, about 86,000 fall injuries involve a dog or a cat, according to the Fall Prevention Coalition. But there are some things you can do to make your home safer without giving Fido away...
Make sure to keep your pet's toys and food and water bowls away from areas where you walk. Keep the area around their water bowls dry to avoid slipping on any splashed water. Try a mat with a rubber bottom under the bowl to keep it in place and sop up any water.
Obedience training also helps keep your dogs from jumping or running past you on the steps. And as the coalition recommends, try a small bell on your pet's collar so you can hear it underfoot if you can't see it.
4. Don't forget the bathroom and hallways. Slip-proof the bathtub with a nonslip mat. These typically go for less than $20 on Amazon or at retailers like JC Penney or Bed Bath & Beyond.
And add grab bars for extra security. You can find them on Amazon if you're a do-it-yourself installer, or you can hire someone to professionally install some for you.
Finally, add a night-light. As we get older, our vision tends to get worse in the dark. Adding night-lights along hallways and in bathrooms can help make walking at night safer.
5. Get your eyes checked. Vision problems can lead to missteps and falls. They also impact you psychologically. One 2012 study from Ophthalmology found that folks with glaucoma had a greater fear of falling than those without... which can greatly reduce quality of life.
Now, some research points out that vision testing alone won't reduce the number of falls. But it does reduce falls if you combine it with other therapies (more so than if you only do the other tips on this list). That's why checking your vision is so important.
The usual recommendation is an annual eye exam. But I suggest testing yourself at home more regularly. Cover one eye, then try to read at a distance and up close. Repeat for the other eye. If you notice a problem or any changes, go in for an exam sooner rather than later. Knowing and correcting any problems will help keep you safe.
What We're Reading...
- Something different: Another good reason to skip that morning muffin.
Here's to our health, wealth, and a great retirement,
Dr. David Eifrig and the Health & Wealth Bulletin Research Team
July 16, 2019