Reducing Your Falls & Your Risk Of Fracture

Talk About The Fear of Falling & Your Calcium
Plus Vitamin D Intake

BY LYNN KOHLMEIER
PUBLISHED IN "ADULT CARE RESOURCE MAGAZINE, APRIL-JUNE 2006

Did you know that 35 to 55% of healthy men and women over 65 years old fall each year?1 Wrist fractures always occur after a fall, half of spine or back fractures occur after a fall, and 90% of hip fractures occur after a fall. How can you prevent a fall?

Talking about your fall risk is the first step. Over half of elderly men and women are afraid of falling, and in Dutch study, 38% of these adults were so afraid of falling that they avoided many of their usual activities which lead to more depression, a further worsening of balance, as well as quality of life.2 Other older adults deny their risk of falling, possibly a "protective mechanism" so as to maintain their independence. Recognizing the fear of falling and talking about it, giving instruction in exercises for balance and strength as well as assertiveness reduced the fear of falling from 1/2 to 1/4 of the adults in the study. With more confidence as well as safety awareness, less activities were avoided and 3/4 of the adults reported an increase in their physical activity. Recognizing denial and encouraging participation in fall prevention programs is everyones goal.

Find out about exercise programs in your area, SIT AND BE FIT, (509) 448-9438 here in Spokane, has many new tapes and DVDs, one on Balance and another on Osteoporosis Exercises in fact. If you can stand from a chair without using your arms, your risk of falling is less and you can likely do even more. Start slow and easy, but try to work up to 10,000 steps a day if you can, a guideline from the CDC3. The National Institute of Health studied adults over 70 and found that those who practiced Tai Chi fell less often.4 Even if you dont like exercising you may enjoy a short walk or an easier chair exercise session and you will definitely enjoy maintaining your strength and freedom to participate in activities.

Exercise is obviously important, but what else should you do or recommend to someone who you are worried will fall? Ask yourself and others about vitamin D and calcium. Make sure you are getting both, calcium (in a fortified food, dairy or supplement) needs to be split up several times a day to adequately absorb it, where vitamin D can be taken all at one. Vitamin D works not only to increase calcium absorption, and bone mineralization, it also works in muscle to improve strength and balance. Calcium (500mg) and Vitamin D (700units) each day for 3 years in a recent trial5, decreased falls in women over 65 by almost 50% and in women who were less active by 65%, but there was no reduction of falls in men surprisingly.

Though the calcium and vitamin D results from the Womens Health Initiative Study6 did not show fracture reduction in all women, those women 60 to 79 years old who took the 1000mg Ca + 400units vitamin D supplements consistently (~60% of the women took at least 80% of their tablets) did have 29% less hip fractures. There was a slight increase in kidney stones in these women however, so as always, talk to your medical provider about your health before increasing your calcium intake significantly. Dr Jackson, the lead author of the WHI report concluded, "Calcium and vitamin D remain the foundation for good bone health."

In conclusion, do what you can to be more active and reduce your risk of falling, talk about your fear of falling if you have any, and take more calcium and vitamin D for your bones and balance. If you have not had a bone density (BMD) test in more than 2 years, ask your provider to call or email one of the Spokane Osteoporosis Centers in your area to schedule a BMD Test for you (509-777-5000 or Osteoporosis@comcast.net).