The Hidden Dangers of Falls, Understanding the Impact on Senior Health

by Dr Edward Chong Kah Chun, Consultant Geriatrician at Sunway Medical Centre, Sunway City

Falls among seniors are a significant yet often overlooked health issue with devastating consequences. According to the World Health Organisation, an estimated 684,000 fatal falls occur globally each year, making it the second leading cause of unintentional injury deaths after road traffic injuries. Notably, adults over 60 account for the highest number of fatal falls, underscoring the urgent need for fall prevention and awareness in this vulnerable population.

Dr Edward Chong Kah Chun, Consultant Geriatrician at Sunway Medical Centre, Sunway City (SMC), stresses the importance of addressing this growing concern. He explains, “Falls are not just a physical issue; they also carry significant psychological and social implications.”

Understanding the Causes of Falls 

As people age, the risk of falling becomes a serious concern, with factors ranging from physical decline to environmental hazards playing key roles. Dr Edward explains, “Physical decline is a significant cause, as ageing often leads to muscle weakness, sensory losses, and certain diseases such as dementia, gout, arthritis and diabetes. These intrinsic factors collectively increase the likelihood of falls. Extrinsic factors such as environmental hazards also play a crucial role. Common dangers in homes and public spaces, such as slippery floors, poor lighting, and uneven surfaces, can significantly contribute to the risk of falling.”

Additionally, some medications commonly prescribed to seniors can elevate fall risks. For example, anti-hypertensive drugs used to control blood pressure may cause dizziness or imbalance if blood pressure drops too low. This can make seniors more prone to falls. “Vision impairment and hearing loss, which become more common with age, further complicate mobility and safety,” Dr Edward adds. 

Immediate and Long-term Consequences of Falls 

Falls can have both immediate and long-lasting effects, ranging from minor injuries to life-threatening complications. Physical injuries such as fractures or head trauma often require urgent medical attention. But the consequences go beyond physical harm—emotional and psychological effects are equally significant.

The fear of falling (FOF) describes a phobic reaction to standing or walking. Prevalence rates among older persons for FOF range from 20 to 39% overall and from 40 to 73% in those who have fallen. Dr Edward shares, “This FOF creates a vicious cycle: inactivity leads to muscle weakness and poorer balance, which increases the risk of future falls. Moreover, falls can rob seniors of their independence, often necessitating a move to assisted living or long-term care facilities—an emotional and financial burden for both the individual and their family.” 

After a fall, injuries are common and tend to be more severe as people age. Over half of all falls result in at least a slight injury, such as a bruise, sprained ligament, or strained muscle. More serious injuries include broken bones, torn ligaments, deep cuts, and damage to organs such as a kidney or the liver. If falls are left unattended, they can lead to delayed complications such as dehydration, pressure sores, internal bleeding, or infections, which can develop into serious health problems if not promptly addressed. In the worst cases, falls can increase mortality risk, emphasising the importance of swift medical intervention.

Effective Strategies for Fall Prevention

Preventing falls is crucial for maintaining senior health. Dr Edward outlines several effective strategies to reduce fall risks:

•       Regular medication reviews can help minimise side effects like dizziness or imbalance, which can increase the likelihood of falls. Seniors should always consult their doctor before taking supplements, as drug interactions can lead to unexpected side effects.
•       Creating a safer home environment with simple adjustments, such as removing loose rugs, improving lighting, and installing grab bars in key areas like bathrooms, can significantly reduce potential hazards.
•       Wearing proper footwear, such as covered shoes with non-slip soles. These shoes provide far better stability than slippers or slip-ons, helping to prevent falls caused by poor foot support.

Furthermore, Dr Edward recommends that older adults engage in regular strength and balance exercises, such as Tai Chi, Qigong, Yoga, and Sit-to-Stand exercises, which can help improve physical stability and regain confidence. “If the medical conditions allow, older adults are advised to have a high-protein diet with more protein and fibre intake to help with their muscle strength and health, contributing to better balance and strength,” he notes. This is particularly important because everyone loses muscle with age, approximately 3% to 5% each decade after age 30, and inactive people lose the most.

Awareness of the risks of falls among seniors is essential. Families and communities must proactively protect seniors and promote health initiatives in senior care. As Dr Edward aptly puts it, “Ensuring the safety of our seniors is not just a medical responsibility but a societal one.” By understanding the causes, consequences, and prevention strategies, we can help reduce the incidence of falls and improve the quality of life for our senior population.

At SMC, the Geriatric Centre of Excellence also has a “Fracture Liaison Service Programme” for those aged 55 and above with a recent fragility fracture diagnosis and treatment to prevent future injuries. They involve a multidisciplinary team of geriatricians, orthopaedic surgeons, emergency physicians, physiotherapists, pharmacists, nutritionists, dieticians, and occupational therapists to provide comprehensive care for older people. 

Sunway Medical Centre is Malaysia’s biggest private quaternary hospitals, renowned for its high standards. It holds accreditations from the Australian Council on Healthcare Standards (ACHS), the Malaysian Society for Quality in Health (MSQH), and the Joint Commission International (JCI), reinforcing its commitment to delivering top-tier healthcare.