Studies look to long-term fall prevention

One out of every three seniors falls every year.

Yet, though the problem is well known and preventive steps seem to help, researchers still struggle with the best methods of preventing harm long-term.

Now several studies will examine drugs, technology and individualized plans that may help doctors keep those 65 and older upright and uninjured.

“If we can identify people at fall risk and apply some kind of program or prevention in the home or elsewhere to mitigate that risk of a future fall, maybe we will be able to keep a number out of the doctor’s office, having to visit the emergency department or from dying,” said Glenn V. Ostir, a researcher at the University of Maryland.

The newest study by the university’s medical school will involve up to 500 patients who have come to an emergency department for any reason but have a fall risk, said Ostir, director of the Program on Aging, Trauma and Emergency Care, which is leading the work.

Researchers will take extensive histories and even go home with patients to develop individualized programs that could involve exercise, a review of medications that may cause drowsiness or dizziness, eye tests and modifications to homes to minimize hazards.

The Johns Hopkins University is also one of 10 institutions recruiting seniors for a five-year study that will test whether such individualized plans offer better prevention than generic instructions on preventing falls for those 75 years and older.

Thurmon Lockhart, a professor in the School of Biological and Health Systems Engineering at Arizona State University, has studied the mechanics of falling. He said problems arise as the elderly become increasingly frail, their senses and muscles degrade, and their ability to react to a slip is delayed enough that they can’t stop themselves from falling.

Understanding the process helps inform the treatments, Lockhart said.

Lockhart and others are working on an iPhone app that can cheaply and easily assess ongoing risk by using the device’s sensors to test stability. Researchers also are studying drugs that can improve balance and help seniors react faster, with testing on Parkinson’s patients, who tend to be rigid and unstable. Both the technology and the drugs could be available in several years.

“These could be the answer, along with training,” Lockhart said. “For now we’re in trouble. We really don’t have a good solution for everyone.”