Reducing the Risk of Falling
Q I’ve read that a new analysis of studies including nearly 80,000 people, aged at least 60 years and older, confirms that certain types of widely prescribed drugs, such as antidepressants and sedatives, can increase their risk of falling. Is this true?
ROBERT, Los Angeles
A Yes, it’s true. But what should be more widely known is that there are nutrients that can reduce this risk, while enhancing health. For example, resveratrol has been found to delay functional decline. In several studies, researchers found a variety of evidence for the beneficial role of resveratrol in preventing disease and retarding the aging process (see
“Resveratrol Combats Age-Related Diseases” in the September 2008 issue). In elderly mice on a standard diet supplemented with resveratrol, there were marked reductions in signs of aging (compared with the controls), including:
- Improved structure and strength of bones, indicating better bone health (which, in humans, would mean a reduced risk for osteoporosis). This was true for both the lower and higher doses of resveratrol.
- A significantly reduced incidence (with the higher dose of resveratrol) of cataracts at 30 months of age versus 18 months, when there was not yet any difference.
- Improved locomotor function, i.e., improved balance and coordination, with the higher dose of resveratrol. This means a reduced risk of falling, an obvious advantage in the elderly.
Low vitamin D intake has been linked to impaired muscle strength, increased fall risk, and increased fracture risk along with increased rates of bone loss. Furthermore, treatment with vitamin D has been found to reduce fracture risk in elderly postmenopausal women. One study reports a double-blind, randomized trial of 122 elderly women (mean age 85.3 years) in long-stay geriatric care who received either 1200 mg calcium plus 800 IU vitamin D (Cal+D) or 1200 mg calcium (Cal) per day over a 12-week treatment period. The Cal+D treatment group accounted for a 49% reduction in falls owing to significantly improved musculoskeletal function. In fact, a single intervention with vitamin D plus calcium over a 3-month period reduced the risk of falling by 49% compared with calcium alone.
Cognitive enhancers, such as acetylcholinesterase inhibitors (AChEIs)—including galantamine—improve attention and executive function. Would it not be valid to think that cognitive enhancers may reduce fall risk in elderly people in the early stages of cognitive decline by improving their gait and balance performance due to an enhancement in attention and executive function? Galantamine has already shown benefit for gait in patients with Alzheimer’s disease and in patients with Parkinson’s disease, along with decreases in freezing of gaits and falls. Currently, researchers have designed a double blinded randomized controlled trial with 6 months follow-up in 140 older individuals with mild cognitive impairment (MCI) to test the hypothesis that AChEIs, such as galantamine, might be able to reduce the risk of serious falls.
- Bischoff et al. Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Min Res 2003;18(2):343-51.
- Montero-Odasso M, Wells JL, Borrie MJ, Speechley M. Can cognitive enhancers reduce the risk of falls in older people with Mild Cognitive Impairment? A protocol for a randomised controlled double blind trial. BMC Neurol 2009 Aug 12;9(1):42.