When I play golf with my sons now, things just aren't what they used to be. It's difficult to admit, but when I observe them and then see my results, it's clear that my physical abilities are waning. Was this inevitable and must I expect that there will be a gradual decline year by year?
Overshadowing the question of my shrinking athletic prowess is the fact that one of the key public health issues of our time is how to limit falls in the elderly. Each year one in every three adults over 65 has a significant fall.
These incidents can lead to moderate to severe injuries, with leg and head trauma being the most common. Falls are also the leading cause of accidental death in this age group, with 2010 statistics showing that 21,700 older adults died from unintentional fall injuries. Although men are much more likely to have a fatal event, just recently it was reported that Walt Disney's last surviving daughter, Diane Disney Miller, died from injuries sustained in a fall.
In 2010, there were 258,000 hip fractures in the United States with over 95 percent of them caused by falls. Interestingly, the rate for women is almost twice that for men, largely because of a higher incidence of osteoporosis. Not only are these injuries often devastating because of the loss of independence, but they can also lead to emotional isolation.
The Centers for Disease Control and Prevention recently reported that the risk of falling increases exponentially with age and that older adults who have previously fallen are two to three times more likely to fall within the next year. The bad news is that as the wave of baby boomers ages, fall-related death rates and hip fracture hospitalization rates may well increase. The good news is that nearly two-thirds of the falls occur in and around the home and many of these should be preventable, if we focus on the real causes.
So, since I am already a proud Medicare beneficiary, what should I do and what can society do to address this problem? Just like the rest of my contemporaries, I want to improve my chances at long-term quality of life and the country should seek a system that makes it more likely that seniors will be able to stay at home longer, be more productive, and consume fewer healthcare resources. Fortunately, it appears that there are several proven strategies for us older folks, some requiring individual initiative, while others may be expedited by financial incentives from policymakers or insurers. For example:
1. Have your medicines -- both prescription and over the counter -- evaluated by a health professional to identify those that, because of side effects or interactions, lead to dizziness or drowsiness.
2. Get your eyesight checked regularly to make sure you have glasses that maximize distance vision for walking both inside and outside.
3. Schedule a safety audit in your home that will look at lighting issues, tripping hazards, and the necessity of adding grab bars in bathrooms and railings along stairways.
4. Get regular exercise. You should concentrate on leg strength, flexibility, and, most importantly as noted by recent research, balance. The Mayo Clinic suggests the use of Tai Chi, the Chinese stress-reducing system, which requires no special equipment and can be done indoors or out, either alone or in a group.
5. In addition to weight bearing activities, a diet rich in calcium and vitamin D will lower hip fracture risk. Osteoporosis screening should be considered, particularly for women, followed by treatment, if needed.
These suggestions are not complicated and don't depend on the emergence of new drugs for cancer or heart disease, but they could mean just as much for my generation. Personally, I may never again hit the golf ball as far as my sons, but I hope to be able to enjoy their company in friendly competition for many more years.
Foster is a Charleston surgeon and a former senator from Kanawha County.