Elderly with Osteoarthritis: Reducing the Risk of Falling
A person over the age of 65 is at a higher risk of falling. That risk increases substantially if that person who is over 65 also has osteoarthritis. Of the people who do fall, one in 40 will be hospitalized1 and of those, half will be dead within the year. Yes, falling is a deadly serious problem.
Why is the risk of falling higher when someone has arthritis? Anyone one who has osteoarthritis in the knees, hips, back, or ankles will tell you that walking becomes more difficult. As mobility becomes more difficult, tripping on that darn rug gets easier. The more joints involved, the more the risk of falling increases. Pain makes matters even worse. And sometimes joint replacement surgery makes falling more likely.
Just when you thought surgery was supposed to help the situation, one study showed that an elderly individual was much more likely to fall within the year after having a knee replaced.2 The problem with that new knee is that the range of motion can be rather limited, especially if physical therapy has not been a top priority. Without the normal swing of the leg, the ability to walk is greatly impaired. Surgery or no surgery, those with arthritis experience the same problem: difficult to walk, easier to fall down.
The key to improving upon this dangerous situation is to prevent the falls. The Centers for Disease Control has some good, basic information about fall prevention. UCLA published a wonderful article about fall prevention too. In it they wrote:
Physicians should caution patients to eliminate home hazards such as loose or frayed rugs, trailing electrical cords and unstable furniture. Patients and their families should be advised of the importance of specific environmental improvements adequate lighting, bathroom grab rails and raised toilet seat, secure stairway banisters, raising or lowering bed and an easily accessible alarm system are possibilities. A visiting nurse or any experienced person can perform a home evaluation to suggest modifications.3
A good physician will be continuously monitoring for falls and the risk of falls in people over the age of 65 because it is just that important. A good physician will also know that many medications increase the risk of falling too.
Other ways to prevent falls involve improving the strength and balance of the individual. Physical therapists often work towards a goal of fall prevention. Some even have specific community-based classes for the elderly to help keep individuals out of the hospital with fall-related injuries. In addition to traditional physical therapy, aquatic exercise has been shown to reduce the risk of falls in someone with hip osteoarthritis.4 But good therapy is only as good as the pain control. Poorly controlled pain increases the risk of falling. A person is less likely to stumble if the pain from arthritis is well controlled according to one recent study that looked at people with knee arthritis.5
Whether an individual has arthritis in the knee, hip, back, foot, ankle or all of the above, the risk of falling is much higher than in someone who does not have joint arthritis. Because falling is a prominent cause of mortality, everyone needs to be aware of the risk and what to do about it.
- J Gerontol (1989) 44 (5): M112-M117.
- Arch Orthop Trauma Surg. 2012 Apr;132(4):555-63
- Age and Ageing, 2006; ii37-ii41
- J Aging Phys Act. 2010 Jul;18(3):245-60
- Gait Posture. 2007 Jan;25(1):106-11
Christina Lasich, M.D., wrote about chronic pain and osteoarthritis for HealthCentral. She is physiatrist in Grass Valley, California. She specializes in pain management and spine rehabilitation.