It’s a sad fact that as we age, falls can kill. About every eleven seconds or so someone over the age of 65 takes a tumble and lands in the emergency room. Every 19 seconds, an elderly American dies from a fall. These are horrible statistics. This is even more frightening: The highest incidence of falls is seen in very old people [Hartholt et al. 2011b; Campbell et al. 1990]. Campbell and colleagues showed that the incidence rate of falls (number of falls per 100 person years) increased from 47 in people aged 70–74 years to 121 in those aged 80 years [Campbell et al. 1990, referen.ce https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4125318/.
This is your mother, your father, your grands we’re talking about.
The average American who is sixty plus is taking some fifteen prescriptions a year, and that jumps to eighteen about ten years later (https://www.huffingtonpost.com/ann-brenoff/elderly-taking-too-many-pills_b_7079060.html). Those who are institutionalized are even more medicated. This is called polypharmacy, and it’s one of the biggest causes of death among the aging and elderly.
Antidepressants, hypnotics and opioids are among the top enemies of our balance. The older we get the more likely we are to be over-prescribed. Add to that the sedentary nature of our aging population. Is it any wonder falls kill more older people than anything else? This is particularly true when in so many cases, Mom slams her head into the bathroom sink on the way down, and sustains a Traumatic Brain Injury at the same time she breaks her hip. The doc can fix the hip, but then Mom deteriorates rapidly. This doesn’t need to happen.
Polypharmacy fools us into thinking we have Alzheimer’s (and some cause it, which is even worse) when in truth, if we canned the capsules, we’d immediately think more clearly and get our brains back. And our balance.
OK, I Have An Admission to Make
At 65, I fall into that statistical category. Only I don’t take these drugs, or at least I didn’t until I had a really badass rotator cuff surgery on May 22. I was given opioids. They do two things: don’t stop the pain and they make me drunk. The day after surgery I did a full face plant into the base of a wooden bookcase. Not a good thing for someone who’s had nineteen concussions from sports. Not at all. Then I fell twice more, right on top of the surgical incisions, because of the drugs. I threw them out, and dealt with the pain instead. I will never take those drugs again.
My surgeon refers to them as poison, and he’s right. So are a great many other drugs both over the counter and prescribed, drugs we take every day because we believe they are safe when they are anything but.
Last October I cycled off some ten or more drugs, many of which had been prescribed for PTSD (I’m a veteran). They had godawful, horrific side effects, including suicidal thoughts, which they were supposed to control. Nonsense. I was taking a number of medicines for depression, and they were causing depression, as well as brain fog, dizziness, memory loss and constant suicidal thoughts. What a lovely toxic stew.
Here’s the thing.
Inevitable Falls are a Fallacy, Pardon the Pun
The National Council on Aging advises that falls are the leading cause of fatal injury. It doesn’t have to be that way. There are several potential reasons and a number of positive responses:
- One of the main reasons elderly people fall is because of overmedication. So much of what we take meds for are lifestyle issues. Bad food, sedentary lifestyle, lack of engagement, any number and combinations of factors all of which lead to a host of problems that better choices would automatically solve. Polypharmacy is a huge actor when it comes to the aging population, as so many caregivers don’t talk to each other confer or discuss the many meds they’re handing out like Halloween candy. As a result, people end up taking far too many meds, each of which has side effects, most of which doctors either don’t know enough about or don’t bother to ask the hard questions about for each individual patient. That leads to all manner of drug interactions. People have come to assume that the symptoms are “just part of aging.” Bullshit. Pure unadulterated bullshit.
- By stopping the meds, doing our own research and committing to more movement and better food, we automatically improve our health, our balance, and potentially reduce the incidences of falls. It only makes sense. Rather than assume a pill or worse a whole raft of pills will make us better (in many cases, they won’t), making incremental improvements in how we treat this carriage that hauls us around every day will directly impact how often, or whether, we fall.
The Damnation of Depression
When people feel depressed, and I have most assuredly been there, they have a hard time wanting to take care of themselves. Life goes grey and even the most lovely spring day full of fragrance and flowers looks like death warmed over. I am intimately familiar with that feeling. I exercised anyway, regularly and hard, which helped. However until I dumped the damaging pills which were prescribed for depression, I didn’t stop being depressed. That’s the definition of insanity.
Old people don’t automatically become depressed. I would posit — since I’ve been there myself and have had direct experience with both sides of this issue- that pills we shove into our parent’s gullets make us depressed. Plenty of research backs this up (https://www.npr.org/sections/health-shots/2018/06/12/619274492/1-in-3-adults-in-the-u-s-take-medications-that-can-cause-depression).
For most of us, the more depressed we are, the less we exercise. The less we exercise- at any age, but most especially as we age, the more terrified we are of falling.
Fear of falling is one of the biggest reasons we fall.
People sit all the time, stop moving, stop doing, and effectively live inside the prisons of their immobile bodies because they become terrified of falling. Pills make us tired, forgetful, lethargic. It’s ever so much easier to sit on a comfortable couch, pull out that big bag of cheese popcorn and watch shows all day. After all, we’ve earned the right as oldies to relax, right?
Wrong. Because when you relax ALL the time you speed up the dying process. Not only that, anti-depressants kill you off a lot younger. (https://www.peoplespharmacy.com/2017/09/21/will-dangers-of-antidepressants-shorten-your-life/) That’s not all. New research (https://www.karger.com/Article/Abstract/477940) shows that among other things,
“although each AD [antidepressant] has unique pharmacological effects, they all interact with evolutionarily ancient biochemical systems that regulate multiple adaptive processes throughout the brain and the periphery. Thus, while each AD probably has a distinct symptom profile, there is good reason to suspect that they all degrade the functioning of some adaptive processes in the body.”
Let me tease out this incredibly important phrase: “evolutionarily ancient biochemical systems that regulate multiple adaptive processes throughout the brain and the periphery.” In other words, we were designed to be well. We were designed to deal with most anything life throws at us. Miraculously, magnificently well-designed. Until we interfere with bad food, bad habits, no exercise, and far too much stress.
In other words antidepressants screw us up, and we end up sitting a LOT more, which is the very thing that will guarantee weak muscles and poor balance.
The very thing — exercise — that will best ensure they won’t fall later in life- which builds muscle, confidence, balance, and assurance of movement- is what so many folks stop doing. It’s a vicious circle.
Sitting too much is serious shit
Even if we free ourselves from the drugs that addle our brains and interfere with our bodies’ natural ability to heal, too many folks sit because they’re afraid to get up and move around. Sitting all day every is very nearly as serious a problem as taking too many drugs.
How serious is constant sitting?
“We’ve become so sedentary that 30 minutes a day at the gym may not counteract the detrimental effects of 8, 9 or 10 hours of sitting.” Genevieve Healy, PhD
This isn’t just Ma and Pa. It’s you and me. The average 10–14 hours every single day we sit from driving to work to working at a desk to sitting and watching TV. It’s killing us off. The body was never, ever designed to do this. We are uniquely, perfectly designed to move until the day we die. Hopefully in mid-stride.
It’s Just Too Much Work
I remember heading down the steps at Red Rocks Amphitheater here in Colorado one time doing laps and watching an old couple head up from the bottom. The man was assisting his wife, who was attempting to make it up just the first few steps of the 200 that are on the south side.
She was struggling mightily just to make up the first few steps.
That’s a statistic in the making.
The huge thigh muscles of our legs, the biggest muscles in the body, are what guarantee our ability to get in and out of our chairs, up and down the stairs, have the confidence to propel us forward and back. You want to squat on the floor to play with your grandkids? Great. Now get back up- without casting around looking for something to help pull you back up. That’s leg strength.
I Could Never Do That
Last year I broke my back in four places riding a horse in Kazakhstan. I had to wear a tight corset for months. I trained anything and everything that I could that didn’t involve twisting or bouncing. In December at the Denver Airport I was waiting to board when early boarding was called. My 30-lb backpack was in the chair next to me, angled so that all I had to do was squat, slip my arms through the straps and get up.
I did just that in one smooth motion. As I rose, I noted a pair of shiny dress shoes belonging to man standing very close to me. As I stood I looked at him. Mid-seventies, very tall.
He gazed at me solemnly and said, “I could never do that.”
Yep. You’re right. If you stop exercising, if you stop working your body the way it’s designed, it’s guaranteed to deteriorate very quickly. Worse, if you buy into the lies about the so-called automatic rapid deterioration that comes with age, then by god you’re going to want to be right about how “I could never do that.”
Sarcopenia, which is the loss of muscle mass as we age, is inevitable. But how much we lose is strictly dependent upon how willing we are to exercise and push ourselves, which have a huge effect on our mobility, strength and balance. This man wouldn’t dare get on the floor with his grandkids. He might not be able to get up.
That’s criminal. It reduces his quality of life and limits him to a narrow existence. I wouldn’t wish that on anyone.
Twenty-seven thousand people die every year from falls. In 2013, the cost of fall injuries was $34 billion. As more of us age, this cost is likely to double by the year 2020.
There is absolutely no reason for this. The very best ways to prevent falls is to move. Exercise. Get up and out and move around. Play with your grandkids. Do yoga. Stay active. Build your body confidence. You’re not helpless. You can do something about this right now. There are local gyms, local activity centers close by. Pools offer plenty of water aerobics. Start at the level where you are, and build up over time.
Do Your Research and Take Charge. This is YOUR Body, YOUR Life
As you begin this process, research, question and challenge every single pill that your doc wants you to pop. ALL of them. Far too many caregivers prescribe without understanding either interactions or long-term side effects. This isn’t necessarily intentional, but it is benign neglect. Doctors are deeply fallible and flawed people who are not provided incentives for wellness. Too many simply believe their Rx reps and are often paid or provided incentives to push pills and procedures whether or not they’re called for. That’s what a for-profit healthcare system engenders. That’s why it’s your job, my job to research, challenge, question and take charge. Don’t let a title intimidate you.
My best friend’s 95-year-old mother regularly got prescribed pills by her doc “just because of her age.” She got on to the computer, did her research, and refused every single one. That’s likely one reason she maintained independent living until she finally did take a serious fall and hit her head. My take is that if Deen had exercised more, that might have been avoided. We don’t know that, but even so, she likely extended both her life and the quality of that life by refusing to be over-medicated.
If these are your parents we’re talking about, it might take some convincing. But it’s a matter of life and death, no kidding around. Sitting kills. Not only does it guarantee muscle atrophy, but Chronic Sitting Disease is linked to a host of other problems in older folks. The more we sit, the more likely we are to fall when we do eventually try to stand up. Muscles don’t work unless we use them(https://www.health.harvard.edu/blog/much-sitting-linked-heart-disease-diabetes-premature-death-201501227618).
Constant sitting is NOT a viable option- whether it’s you or a parent or someone you love.
The more you sit, terrified you’re going to fall, the more likely you’re going to fall.
Break the cycle. Stop the meds. Get up and move. Remember how hard it was to sit still as a kid?
Yes. That feeling. It would be a good one to bring back.