Falls can be very serious
by: Dr. A. R. Scopelliti
Ø Falls are the leading cause of both unintentional injury and death in persons 65 and over.
Ø Falls are the number one reason for admission to a nursing home.
Ø One third of all people over 65 fall at least once a year. Half of those who fall do so repeatedly.
Ø Almost all fractures sustained by seniors are the result of a fall.
Ø Falls are the most common cause of injuries, emergency room visits and hospital admissions for trauma.
Ø Half of all seniors who fall in their home and require hospitalization will go straight from the hospital to a nursing home.
Ø Falls cost over $20 Billion in 1998 and are estimated to cost over $30 Billion by the year 2020.
Ø Up to 50% of falls are preventable.
How to find out if you have a problem
The first thing you should do is to see a physician who performs computerized balance screening. Only a licensed physician is qualified to evaluate your balance and your risk of falling.
Falls risk can be evaluated in several ways, but some physicians now offer a computerized balance test called CAPS that uses normative data established by NASA. This simple test, which takes only 60 seconds, measures your balance and compares your score to the scores of other people your age and stature. In our office, there is no charge for the CAPS screening test, which we perform routinely as a community service.
What if your CAPS score is abnormal
If your CAPS score is abnormal, don’t be alarmed. Everyone has a problem with balance at some point in their life. Balance problems can be caused by such simple things as flu, lack of sleep, effect of medications, etc. In such cases the problem will resolve itself without medical intervention.
But sometimes when a patient shows signs of a balance disorder, the reason may not be immediately apparent. In such cases, it’s important to find out what is causing the problem.
Evaluating your balance problem
In our office, we will obtain a necessary medical history from you, check your visual acuity and perform a simple hearing test. We will do an evaluation that will include checking your reflexes, sensation, muscle strength and tone, coordination, gait, stance, etc. Then we will do a series of simple, non-invasive balance tests, using the sensitive CAPS™ force platform and additional special software. We will also look for signs of nystagmus, a rapid, jerky movement of the eyes that often indicates the presence of a balance disorder.
What happens next
Once we make a diagnosis, we will decide what treatment is best for you. In most cases, we will perform gait and/or balance/vestibular therapy, to which almost all patients respond very well. We will additionally review ankle, knee and hip strategies to incorporate better balance as well as to avoid falls in the first place. Manipulations may be utilized when appropriate to change the way joints give information to your brain about your body’s position in space.
It may be fun to spin around and fall when you’re very young… But falls can have serious consequences for older adults
Why get your balance checked?
A balance screening helps us as physicians identify patients who may be at an increased risk of falling, and falls can often have disastrous results, particularly for older patients. Falls can result in broken hips, other fractures, head trauma and other serious injuries - even death.
There are also other important reasons. Balance problems can be the first sign of other health problems such as diabetes, cardiovascular diseases, neurological disorders, traumatic injuries and many others, so identifying patients with abnormal balance can be invaluable in the detection of other serious conditions.
We now recognize that older people often do not know when they have a balance problem or are at increased risk of falling. Since they do not know, they do not complain to their physician. Because the patient does not complain, the physician does not investigate. The tragic result is often that nothing is done until a fall has already occurred.
This is why we now stress the importance of early identification of balance problems.
The most important part of reducing the risk of falls is always identification, because ... before you can help prevent a fall, you first have to find out who is at risk of falling
Dr. Scopelliti is a Fellow of the American College of Functional Neurology and a Fellow of the American Board of Vestibular Rehabilitation. He is currently president of NJCCN. His practice is located at the 279 Medical Arts Bldg at Monmouth Medical Center, in Long Branch, NJ. His office focuses on the drug free management of patients with vertigo, dizziness, imbalance, presyncope, dystonia, ADD ADHD, various stages of coma, and other neurologic as well as behavioral/cognitive disorders. Dr. Scopelliti has also authored several Lectures and Software for Neurologic and Vestibular Rehabilitation. Dr. Scopelliti has a wealth of information updated weekly on the web at Jersey Shore Regional Center For Vertigo, Dizziness, Dystonia and ADD ADHD. Visit Dr. Scopelliti’s Guestbook to see what real patients have had to say.
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