On 01 Nov 2025, Seniors Today hosted their weekly Health Live Webinar with Dr Aarthi Kannan, who spoke on and answered questions about Fall prevention in Seniors.
Aarthi Kannan is a consultant Geriatrician, Geriatric Clinic at P.D Hinduja Hospital and Medical Research Centre at Khar, Mumbai.
The practice of geriatrics has been around for a while even though qualified super specialists in Geriatric Medicine are very few. So far, it is other specialists which include orthopedicians, general surgeons, medical specialists who have been taking care of the elderly.
Thus, the onus of taking care of a geriatric patient lies with everyone and has been fulfilled to a large extent by the doctors who have already been in the system.
The specialised care and knowledge that need to be tailored for a geriatric patient and delivered, and the training on how to deliver it to an electrolyte patient lies with a specially trained and equipped Geriatrician/ geriatric physician.
If it is an emergency situation or emergency care that you need, you need to reach out to the A&E department (Accident and Emergency), because life is first; if it is primary care and advice that you require then you should reach out to a geriatrician as a first point of contact.
One of the biggest concerns around ageing- for the individual, the children and attendants is how to stay independent and prevent falls.
It is not just about staying healthy and managing chronic ailments. It is also about staying independent.
Fall prevention is now a commonly discussed topic wherein everyone, including neurologist, internal medicine specialist, physiotherapists.
This is because it is estimated that every 1 in 3 adults over the age of 65 years fall.
In those over 80 years of age, the risk of falling is even higher.
Consequences of fall:
- Hip fracture, wrist fracture
- Soft tissue injury
- Loss of mobility: leading to muscle weakness and loss of balance
- Head injury
- Loss of independence
- Fear of falling: psychological fear of falling
- Social isolation: since the patient is worried about falling, they tend to avoid going out/ meeting people.
- Economic consequences: frequent and longer hospitalisation, constant care giving efforts
Reducing fall risk is equal to preserving quality of life.
Preventing falls needs to be a proactive effort.
Key risk factors:
- Age > 65 years
- History of previous falls
- Lower body weakness, poor balance/ gait
- Visual impairment
- Hearing issues
- Medicines that affect balance and/ or cognition
- Home hazards such as poor lighting, loose wires, obstacles in the path, cluttered corridors or hallways
- Chronic conditions such as arthritis, Parkinson’s
- Memory or cognitive disorders
- Uneven surfaces and lighting issues
Major causes of fall:
- Physical and musculoskeletal
- Balance issues, inner ear issues, neurological issues
- Gait changes: shuffling, slow, unsteady gait
- Joint pains such as osteoarthritis, hip and knee problems
- Postural hypotension
- Foot problems or poor footwear
- Decline in vision: cataract
- Lack of hand rails
- Medications: many drugs increase the risk of falls by causing dizziness, low blood pressure, confusion, sedation.
- Poly pharmacy should be avoided
- Medication review is the key
- Visual impairment
- Cognitive decline/ cognitive issues: people with mild to moderate impairment fall more often than people with no cognitive impairment
- Neurological impairment such as stroke, Parkinsonism, neuropathy
- Environment and behaviour: home hazards such as loose rugs/ carpets, mats, poor lighting, cords and clutter on the floor, slippery floor, lack of hand and stair rails, footwear which is slippery
- Behavioural causes includes habits such as walking while on phone, multi tasking, walking in unstable surfaces
All older patients on any of their visits to the hospital should be asked about any history of fall in the past 1 year.
Geriatricians ask about the frequency, circumstances. If the patient has any walking or balancing problems. They also do a gait and balance assessment.
They also review all your medications, vision, hearing
A detailed visual and hearing assessment and evaluation can be advised by a geriatrician if they feel there is an underlying visual, hearing or balance problem.
Your home environment is also inquired about
“Near falls” are also asked about
You need to ask yourself these 3 questions:
- Have I fallen/ neatly fallen this year?
- Am I unsteady while I’m walking?
- Do I feel dizzy when I stand up/ move?
What works/ helps preventing falls:
- Exercise and physical activity
- Balance gait and strength training
- Remove tripping hazards at home
- Install gripping hand bars, grills in bathroom, raised toilet seats, shower chairs
- Improve lighting, use non slip mats
- Supportive footwear with non slip soles
- Medication review and other medical care and prevention
- Keep and updated medication list and bring it to every single hospital visit
- Manage blood pressure, postural hypotension, visual and hearing issues
- Vit D supplementation: 800 IU/ day may be considered for older persons with gait problems and patients that are at a higher fall risk
- Balanced nutrition and hydration
- Annual visual and hearing assessment. Impairment increases fall risk
