Por qué una caída puede ser fatal para los ancianos: riesgos de salud y recuperación lenta

Title: Why a fall can be fatal for the elderly: health risks and slow recovery. Profile: Falls among the elderly are risky. This article provides preventive measures and tips to improve their safety and care.

There are people who, after falling, dust themselves off and get up without any issues, but there are others, especially the elderly, for whom a fall can result in a fracture, or even trigger multiple diseases, putting their lives at risk.

Why do elderly individuals tend to fall easily?

A study published in the "Chinese Journal of Epidemiology" by Southeast University and the Jiangsu Provincial Center for Disease Control and Prevention analyzed over 80,000 cases of accidental fall injuries among the elderly in Jiangsu from 2006 to 2021. The results showed that the proportion of fall cases in individuals aged 60 and over is increasing; although there was a downward trend in the 70 and 80 age groups, the risk of falls in these groups is 1.3 times and 2.6 times higher, respectively, compared to those aged 60 and above. Furthermore, it was noted that fall cases in women over 60 always exceed those in men, with a ratio of 1 to 1.4.

The aging of the body leads to worsening coordination. As one advances in age, particularly after 60 years, there is a gradual loss of bone and muscle mass, degenerative changes in connective tissues and joints, and deterioration in walking balance, vision, and hearing, resulting in a decreased flexibility and body coordination.

Prolonged use of medications may cause some elderly individuals to feel less reactive. Those taking antihypertensives, diabetes medications, antidepressants, analgesics, and others may experience effects on their awareness. Symptoms such as diminished nerve sensitivity, orthostatic hypotension, depression, anxiety, and social isolation may appear, reducing their ability to react and adjust to their environment, thereby increasing the risk of falls.

Due to hormonal influences on the body, many women experience a decrease in estrogen levels after age 50, increasing their risk of osteoporosis and consequently leading to a higher incidence of falls compared to men.

These moments are when elderly individuals are most likely to fall.

Based on the activities conducted at the time of the falls, from 2006 to 2014, the five leading activities were: recreational activities, household/study tasks, work, transportation, and sports. From 2015 to 2021, the top five were: recreational activities, household/study tasks, walking, activities of daily living, and transportation.

Professor Yu Pulin from the National Center for Elderly Medicine and Beijing Hospital stated: “It is not difficult to notice that the lifestyle and pace of the elderly are changing. They used to spend a lot of time at home, but now the time dedicated to exercising and outdoor recreational activities is increasing. This is a positive sign, indicating that the elderly are increasing their physical activity and social participation. However, on the other hand, outdoor activities have also increased the risk of falls.”

In reality, the elderly not only are prone to injuries from outdoor activities, but they may also easily fall at home, which is often considered the safest place. The most common occurrences are slipping and falling in the bathroom, or losing balance when getting up or crouching on the toilet. It is also possible to sustain injuries when getting out of bed if balance cannot be maintained. It is crucial for the elderly to slow down their movements and pay attention to the moments when they are more likely to fall.

Once you fall and stay in bed, complications can arise quickly.

If elderly individuals remain in bed for prolonged periods after a fall, they may develop pneumonia, urinary tract infections, and deep vein thrombosis. This can also accelerate the loss of bone and muscle mass and lead to complications such as pressure ulcers, significantly impacting quality of life and even potentially shortening lifespan.

A fall is the result of a combination of decreased bodily functions in various aspects. The burden of care after a fall often becomes a trigger for family conflicts and economic pressure, ultimately leading to the situation where "one person falls, the whole family becomes unbalanced." According to monitoring by the Chinese Center for Disease Control and Prevention, it has been observed that after a fall, 37.22% of elderly individuals suffer moderate to severe injuries, and after receiving treatment in emergency services, 22.49% require hospitalization.

According to Yu Pinglin, falls among the elderly that result in hip fractures have characteristics such as high mortality rates, long hospital stays, high medical costs, and a greater propensity to cause severe disabilities and loss of independence. Each year, the direct medical costs of falls among the elderly in our country exceed 500 million yuan, with the disease burden ranging from 16 billion to 80 billion yuan. Falls have become a serious public health issue that our country needs to urgently address.

Four things that help the elderly stay away from harm.

Home modification to prevent falls is essential, as the home is the primary place where the elderly suffer falls. It is important to design and adapt the home with a focus on preventing such accidents.

Elderly individuals should supplement their diet with high-quality proteins, consuming moderate amounts of eggs, lean meat, and others. It is also important to add calcium and vitamin D, which are essential nutrients for strengthening bones. Elderly individuals suffering from diseases such as coronary artery disease, hypertension, or diabetes should regularly monitor their blood pressure and blood sugar levels, take their medications on time, and maintain a low-salt, low-oil, and low-sugar diet. It is recommended to avoid tobacco and alcohol, as well as ensure adequate sleep. In this way, they can focus better and have more energy during their activities.

Strengthening daily exercise can be done through activities such as practicing tai chi or dancing in the square. Strength training can also be incorporated by performing exercises like lateral kicks, alternating lunges, maintaining balance on one leg, raising legs while seated, and reaching for the toes when bending. These activities help to increase muscle strength in the lower extremities and prevent falls.

When dressing, it is also important to protect against falls; on rainy and snowy days, it is better not to go out. If it is necessary to go out, non-slip and comfortable shoes and socks should be worn. Clothing should not be too loose or have a complicated design, as ties and other decorations can cause elderly individuals to trip. A personal alarm device can be carried to request help quickly in case of a fall.

Elderly individuals at high risk of falling should learn the proper position for falling to minimize injuries. According to Yu Pin, as a fall approaches, the elderly should try to bend their knees, keep their chin down and arms close to the chest, falling towards the outer side of the thighs. Once the upper body touches the ground, they should roll towards the torso and upper back. If someone witnesses an elderly person falling, they should not rush to help, as lifting them carelessly could cause additional injuries if there are fractures or brain hemorrhages. It is recommended to call 120 immediately and protect the elderly while observing their condition.

In addition to preventing falls, elderly individuals should pay attention to these two things.

Be cautious, as the coordination ability in elderly individuals may deteriorate, possibly causing them to walk unsteadily and frequently twist their ankles. Many elderly people do not take ankle twists seriously, which is a mistake. If proper and timely treatment is not received, this is likely to lead to instability in the ankle joint, resulting in habitual ankle twists.

After a sprain, it is important to follow these steps: stop any physical activity or walking, and sit or lie down immediately, elevating the affected leg to promote venous return. Apply cold immediately, using an ice bag or a cold towel to constrict blood vessels, reduce leakage and swelling. In the first 48 hours after the injury, apply cold every 2 to 3 hours for 15 to 20 minutes. If there has been instability in the ankle, strengthening exercises can be performed, such as balancing on one leg (without support, alternating after 30 seconds on each leg, repeating 6 cycles) and alternating using the toes and heels (sitting in a tall chair, with feet about 5 centimeters off the ground, rhythmically touching the ground with the toes and heels, doing 3 cycles of 50 repetitions on each foot).

Be cautious of fractures. Most elderly people suffer from osteoporosis and joint diseases, so even a slight external force during daily activities can lead to fractures. Elderly individuals who sustain a fracture should remain calm. Some low-severity fractures do not require surgery and can heal with proper protective management, such as using casts, splints, and functional rehabilitation.

But inadequate management should be avoided: do not massage—many elderly individuals tend to massage the painful area after a fracture, which can cause displacement in fractures that were initially non-displaced, leading to secondary damage; do not apply heat—right after an injury, the rupture of numerous capillaries and the extravasation of tissue fluid can cause swelling and inflammation. Applying heat can increase blood circulation, intensify the rupture of vessels, and worsen swelling at the fracture site.

It is said that it takes a hundred days to recover from a muscle or bone injury. Young people may take around three months for a complete recovery from a fracture; for the elderly, the recovery period after a fracture is even longer. If an elderly person also has diabetes, wound healing will be even slower, possibly requiring conservative treatment for at least four months or more to return to normal activities.

The reaction ability, balance, and muscle strength in elderly individuals are lower than before. Even those elderly individuals who are in good physical condition cannot avoid accidents like falls, twists, or fractures. Therefore, elderly individuals should exercise special caution.

As age increases, various bodily functions in elderly individuals inevitably decline. The younger generation should provide sufficient care and attention to the elderly, and once a fall is detected, it must be taken seriously and addressed promptly.