Dr. Ronald
Taylor

Future Research

The Patient-Centered Outcomes Research Institute (PCORI) recently announced an
agreement with the National Institute on Aging (NIA), part of the National Institutes
of Health (NIH), to form a partnership to fund a major intervention study aimed at
preventing injuries from falls in older adults.
Considered a major public health problem, the partnership brings the clinical and
patient communities together with experts in biomedical research to develop and
support a large clinical trial with outcomes that can be translated and implemented in a
real-world setting. The University of Michigan was chosen as one of 10 trial sites in the
country and the only institution in Michigan to participate.

strength may be lost as well.
• Spinal stenosis, a narrowing of the open
spaces within the spine, can put pressure
on the spinal cord and the nerves that
travel through the spine. Spinal stenosis
occurs most often in the neck and lower
back. While some people have no signs
or symptoms, spinal stenosis can cause
pain, numbness, muscle weakness and
problems with bladder or bowel function.

"All of these conditions can benefit from
specific exercise," Taylor says. "From the
ages of 40 to 70, we lose about one half
of our strength from the knees up. Tread-
mills tend to put stress on knees, hip and
back, but a stationary bike and an elliptical
machine exercise quadriceps and the core
required for balance."
Other causes for falls could be safety
hazards in a home or community environ-
ment. To deal with that possibility, Taylor
recommends putting away all loose rugs,
wearing flat shoes such as tennis shoes
and using a cane or walker. (See sidebar for
more tips.)
Every year, roughly one in three older
Americans suffers a fall. Although there are
effective ways to prevent falls, the rates of fall-
related injury remain high, making falls one
of the most common causes of disability and
loss of independence among older adults.
"This is frequently due to the muscle
mass that is lost," says Taylor. "It is surprising
how quickly elderly people can lose muscle
mass and get to the point where they can't
safely stand up and move. Although those
who use walkers seldom fall, most people
are very reluctant to use a walker because
they feel it has a negative stigma. The chal-

lenge is to encourage people to work at
keeping themselves strong and safe."

BALANCING ACT
Balance is a complex function that involves
vision, muscle strength, proprioception (your
body's ability to know where it is in space)
and attention, which are abilities that tend to
decline as we age.
"It's all about balance," says Amy Stea,
patient care coordinator at ActiveRx in West
Bloomfield. "Last November we addressed
residents at Meer and Hechtman [Jewish
Senior Life apartments] about balance and
fall prevention to help them think about their
own safety and independence. We demon-
strated ways they can strengthen their bodies
and work with balance issues. We also gave
them exercises to help them in their daily ac-
tivities, such as getting in and out of a chair."
She says 25 percent of people who get hip
fractures die within six months because they
stop moving and lose their independence.
People start shuffling because they don't
have the lower extremity strength to pick up
their feet.
"We work in groups, challenging clients to
become stronger in a safe environment and
become comfortable with the proper move-
ments," she says.
Bernie and Sharry Friedman of West
Bloomfield attended one of the ActiveRx
four-week classes at its West Bloomfield Ac-
tive Aging Center.
"We worked on exercises that focused
on balance, such as closing your eyes and
marching in place," Sharry says. "We were
also given exercises to do as homework be-
cause we only met once a week. We need to
continually strengthen our legs and core."

The CDC reports that many people who
fall, even if they aren't injured, develop a
fear of falling. This fear may cause them to
limit their activities, which leads to reduced
mobility and loss of physical fitness thus
increasing their actual risk of falling. The CDC
also recommends that a doctor or pharmacist
review a person's medicines, prescriptive
and over-the-counter, to identify those that
may cause side effects or interactions such as
dizziness.
Other recommendations are to get ad-
equate calcium and vitamin D from food and
supplements, to do weight-bearing exercise
and get screened and, if needed, treated for
osteoporosis.

■

PreventionAnd Safety Tips

• Remove loose items you can trip over,
such as shoes on stairs, books, throw
rugs.

• Install handrails on staircases.

• Keep items you frequently use in
cabinets you can reach without using
a stepstool.

• Install grab bars inside and next to the
tub, shower and toilet.

• Use non-slip mats in the shower and
tub.

• Improve the lighting throughout your
home.

• Avoid going barefoot or wearing
slippers.

• Use a shoulder bag, fanny pack or
backpack purse to leave your hands
free.

February 2015 • BOOM Magazine

7

