Tai Chi May Prevent Falls Among Seniors

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Tai Chi May Prevent Falls Among Seniors

New Guidelines Suggest Reducing Certain Medications Also May Improve Balance in

Seniors By Mann

WebMD Health NewsReviewed by J. , MD Jan. 13, 2011 -- Updated

guidelines from the American Geriatrics Society and the British Geriatrics

Society recommend interventions such as the slow-motion Chinese martial art tai

chi along with medication reviews to help prevent falls among the elderly.

The guidelines, which appear in the Journal of the American Geriatrics Society,

were last updated in 2001.

Falls among the elderly are linked to an increased risk for hip and other

fractures and head injuries, all of which can lead to reduced independence,

early admission to long-term care facilities, and even death.

" Given the frequency of falls and the injuries that occur as a result, falling

is as big of a problem as heart attack and stroke, and we need to start taking

it as seriously because falls are preventable, " says guideline author

Tinetti, MD, a geriatrician at Yale University School of Medicine in New Haven,

Conn. " The most effective way to prevent falls is to reduce medication, make the

environment as safe as possible, and improve balance and gait through exercises

including tai chi or physical therapy. "

Tinetti and other panel members reviewed studies looking at fall prevention

interventions published between May 2001 and April 2008 to develop the updated

guidelines.

Fall Prevention 101

Tai chi and/or physical therapy can help seniors improve their balance, gait,

and strength and help stave off falls, the guidelines state.

Medication checkups are also useful for older people who are at risk for falls,

Tinetti says. Medications that may increase falling risk include certain

antidepressants and sleeping pills.

" We should review all the medications and really decide `do they need this

medication at this dose' and determine if the medicine is more likely to cause

overall harm vs. overall benefit, " she says. " If a medication puts a person at

risk of falling, is it really worth it? "

If a medication can't be stopped altogether, reducing the dose may also an

option, she says. No one should ever stop taking or reduce a dose of any

medication without first discussing these risks with their doctor.

Some falls may be caused by poor vision. " Cataract extraction has a lot of

benefits for fall prevention, " she says.

Fall Prevention Is Everyone's Issue

The onus is on everyone involved with the care of the aging population to

implement these guidelines, Tinetti says.

" Nurses, physical therapists, specialists, and anybody who is caring for older

people should be aware of these new guidelines and follow the components that

are relevant to their area of expertise, " she says.

" Older people also need to take more responsibility when they see their care

providers, " she says. For example, say `I want my blood pressure taken when I

stand to see if it drops, and I want you to look at all my medications to see if

any are going to increase my risk for falling or make me unsteady, " she says.

Make Fall Prevention a Focus

P. Grelsamer, MD, an associate professor of orthopedics at Mount Sinai

Medical Center in New York City, says fall prevention strategies should be

implemented in and outside of the home.

Throw rugs, wires, telephone cables can all increase fall risk in the home, he

says. " The bathroom is a dangerous place [and] mats and handles are important, "

Grelsamer says.

" When walking outside and there is a chance it might be slippery, move your feet

apart a little bit because this makes you more stable right away, " he says. " If

you are carrying something, carry it in the dominant hand, so if you fall your

non-dominant hand will break your fall. "

" The main risk is that they are going to break their hip, but other fractures

such as wrist fractures also occur, and emergency surgery is never minor in this

population, " he says.

As for the updated guidelines, " I think it is a very good idea to make sure the

eyes are as good as they can be and that an older person is not on more

medication than they need, " Grelsamer says.

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