Osteoporosis Living with Osteoporosis

When Falling Down Isn't Funny

By Erica Heilman

Falling down is funny. In fact, it is one of the oldest joke forms of all time. But for people over 65, falling can be deadly. According to the Centers for Disease Control and Prevention, falling is the leading cause of injury-related death in people over 65, primarily the result of hip fracture complications. And with a growing population of elderly people living longer and healthier lives, falling is suddenly no laughing matter.

"The amount of human suffering associated with falling accidents is staggering," says Dr. Thurman Lockhart, an assistant professor of industrial systems engineering at Virginia Polytech Institute and State University. "And by 2020, medical costs from hip fractures alone—resulting from falling accidents—are expected to cost the healthcare system between 20 and 50 billion dollars."

In a study sponsored by the Centers for Disease Control and the National Institutes of Health, Dr. Lockhart is researching the mechanics of falling in order to develop intervention strategies. Below, he talks about the mechanics of falling, and offers some practical prevention advice.

Why do people fall more as they age?
There are intrinsic changes associated with the aging process. The changes that increase the risk of falling are a degrading musculoskeletal system, sensory function, and gait changes associated with aging.

How do changes in sensory function affect balance?
The maintenance of balance is organized, or controlled by three senses: Vision, vestibular apparatus and the proprioceptive system. In other words, sight, inner-ear function, and sense of touch, or tactile sensation. We maintain balance with these senses.

So these three factors contribute to falling as we age?
Yes. For example, you can divide slip-and-fall accidents into three different stages: Initiation, or the beginning of a slip, detection, or when we realize we're slipping, and recovery. So imagine when you are slipping and falling. There is the initiation process, where you slip a little bit, and in order to make a recovery, you have to detect that you're falling, which is assessed by your vestibular and proprioceptor system, which is your vision, inner-ear, and sense of touch. After that detection period, you have to make some recovery.

So the initiation, detection and recovery phases are all altered for the older individuals, because we have a gait change and the sensory change, as well as musculoskeletal degradation.

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