Fall Prevention And EyeCare

Most Seniors I know over 70 years old have fallen. Some have laid there for days, others, like my aunt and my mother didn’t tell anyone. Fall Prevention Awareness Day is September 23 2015 and a perfect opportunity to contact your senior citizens and your patients because most likely they have older parents that have fallen to educate them on Fall Prevention. Did you know that one of the top ways to prevent falls is to get your eyes checked?


Falls are the leading cause of death by injury in people over the age of 65. They can be caused by many factors including poor eyesight, loss of balance due to illness, physical conditions including spatial cognition, dehydration or side effects of prescription medications and the aging process.

The Centers for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control reported 9,256,761 unintentional falls in 2011, with an ever exceeding health care cost estimated to exceed $40 billion dollars annually by 2020.

According to the 2012 U.S. Census Bureau report, one in three adults age 65 or older, out of the 40.3 million folks of that age, fall each year. Of those 13.3 million people who fall, 20 percent will suffer moderate to severe injuries that make it hard for them to live independently.

Falling dramatically increases the risk of early death.

Older adults are hospitalized for fall-related injuries five times more often than they are for injuries from other causes. People with visual impairments are more than twice as likely to fall as people without visual impairments.

As with so many other health care issues, it’s time to put more focus on the cause of falls and fractures. Disease and adverse event prevention is always less expensive than treatment.

Balance-Related Falls and Fractures  


To maintain balance, our brains integrate messages they receive from our vestibular system when we are moving, a system that includes eyes, ears, muscles and joints.

Unfortunately, this system ages just like the rest of our body, so the risk of falls and fractures increase as the years go on.

The medical term for this age-related balance condition is called presbystasis.

Nutritional Status

Dehydration, vitamins C, D, K, and the B vitamins associated with elevated homocysteine levels, B6, B12 and folate deficiencies are also linked to balance issues, as are the central macular pigment nutrients, lutein and zeaxanthin, since macula pigment density is linked to spatial cognition, balance ability and reaction time, particularly for older people and interestingly, athletes.

Electrolyte imbalance too frequently caused by prescription drugs that mug minerals including calcium, magnesium, potassium, selenium and zinc are the first dietary suspects where loss of balance and loss of muscle mass is linked to falls and fractures.

Unfortunately, older people sometimes live lonely lives of quiet desperation that include loss of appetite. These people are particularly prone to nutritional deficiency-related falls and fractures.


As we age, we simply don’t get as thirsty as we did when we were younger. Our bladders are not as strong as they once were, so sometimes we avoid drinking as much water as we need.

Dehydration leads to balance issues linked to falls and fractures.

So drink up. Making more trips to the bathroom or wearing leakage protection is easier, less painful and far less expensive than a broken arm, wrist, leg or hip.

Osteoporosis and Fracture

Vitamin K plays a major role in bone health and fracture prevention.

Due to the high prevalence of the prescription blood thinner Coumadin usage in the aging population (Coumadin is a vitamin K antagonist), most well-designed multiples have not included vitamin K for a number of years.

Most physicians also recommend limited consumption of dark green vegetables that include vitamin K to their Coumadin patients.

Fortunately, this issue is becoming less of a problem because more physicians now prescribe PRADAXA to their patients who require anticoagulants. It helps prevent blood clots from forming by working directly on thrombin instead of vitamin K.

Regular prothrombin time checks are not required with PRADAXA and vitamin K dietary restrictions are also not required with this blood-thinning drug.

Unfortunately, this drug is not considered appropriate for people with artificial heart valves.

Calcium has been proven to have beneficial effects on bone mass at all ages. Higher doses of vitamin D than the recommended 600 IU per day is required for optimal bone health and to help prevent falls, as are the trace elements: magnesium, manganese, selenium, zinc, copper and boron, just to name a few.

A well-designed multiple should provide most of these trace elements.

Fall & Fracture Prevention 

Annual eye exams are necessary to identify vision problems that can be addressed through new prescription glasses and contacts, necessary surgery and community-based services, and low vision therapies designed to help prevent falls.

Why doesn’t Medicare cover routine eye exams to prevent the often painful and expensive low-vision outcomes? The public cost of an annual eye exam on healthy older adults and low- vision therapies doesn’t begin to compare to the pain and public costs of treating low-vision-related broken bones that can lead to expensive and emotionally devastating loss of independence and, too frequently, loss of life.

The medical term for our sense of position in space is proprioception. 

Via Ellen Troyer, with Spencer Thornton, MD at  Biosyntrx 

PEARL: In keeping with the Biosyntrx commitment to identifying cause and ways to lower the societal burden of increasing health care costs, as well as pain and suffering, we will frequently address the issue of vision, balance, falls and fractures because low vision, lack of physical conditioning and nutritional deficiencies all play major roles.

References supporting today’s column can be found here.