DIMENSIONS Winter 2002

Falls: Why They Happen and Tips on Preventing Them

by Raymond Houle

Falls are the leading cause of fatal and nonfatal injuries in people 65 and older in the United States. People with dementia are at an increased risk for falls due to physical, behavioral, and cognitive changes.

Physical changes in people with Alzheimer's disease (AD) can contribute to an increased risk for falls. AD can affect vision by altering a person's ability to judge both depth and distance. These problems are often referred to as "visual-spatial" difficulties because they affect the way persons with AD view spaces around them. Something may look closer or farther away, or taller or shorter in height than it really is. Persons with AD may also experience motor changes in their legs that make them more likely to stumble or trip. Finally, medications can be an important risk factor for falls; some medications increase confusion or have a sedative effect, whereas others increase dizziness when a person stands up or moves suddenly.

Behavioral manifestations such as aggression and disinhibition can lead to falls that happen in the home or out in the community. These behaviors place the patient and caregiver at risk for injury, as well as causing stress and social embarrassment. People with AD may get a bit restless and feel the need to move about or stay on the go. This restlessness and increased movement affects concentration and may make a person more likely to experience falls and accidents.

Finally, cognitive difficulties themselves contribute to an increased risk for falls. Due to memory loss challenges, a person may be concentrating so hard on locating an item or a place that he or she is less attentive to objects or uneven surfaces that may be in the path.

It is important to remember that Alz-heimer's disease affects each person differently, and some people may never experience these symptoms. It is helpful, however, to follow some basic principles of safety that can reduce the risk of falling.

Safety Tips to Prevent Falls in the Home:

Safety Tips to Prevent Falls in the Community:

Adapted from:

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