老年人意外跌倒是老年人需要急诊治疗的主要原因之一，据美国疾病预防与控制中心的统计数据“全美65岁以上的老年人每年约有1/3的人意外跌倒1或多次，其结果导致2百多万老年人需要急诊就医，其中约有20000万老年人因跌倒而诱发死亡。”因此，采取相关措施以预防老年人跌倒对增进他们的健康与改善其生活质量具有非常重要的意义。那么如何才能够有效避免或预防老年人意外跌倒呢？彭博我的建议如下：

1、鼓励老年人自觉而经常参加体育锻炼，特别是进行力量和平衡训练（如练太极/ Tai Chi），以改善老年人的肌肉力量和平衡功能有利于增加其行走的稳定性，而预防意外跌倒；

2、改善视力和/或增进室内照明，如验光配镜、治疗白内障或植入人工晶体和控制血糖等；

3、保持地板干燥，并提醒老年人不要行走在湿滑的地板或道路上，和减少下雨天外出或外出时穿防滑鞋等；

4、为老年人配备合适的拐杖，并鼓励他或她使用；

5、改造或重新装修老年人的居所，如尽量减少台阶和增设无障碍通道，并且不要用地毯等；

6、建议老年人在医生的指导下增补钙和维生素D，以增强肌肉与骨骼的功能，而有利于预防意外跌倒，及其降低意外跌倒可能导致的骨折发生率；

7、矫治疾病，如控制血压和对中风后的老年人进行有效康复治疗等亦有利于预防老年人意外跌倒，患有神经肌肉疾病的老年人应积极配合医生接受治疗，以改善肌肉力量和平衡与行走能力；

8、避免药物的毒副作用，如经常服用可能影响血压和/或肌肉力量（如镇静安眠药）的药物，医护人员应该主动而详细地告知老年人这些药物毒副作用，以预防意外跌倒；

9、久坐或卧床的老年人起身时动作不宜过快；避免过长时间取蹲位休息，特别是应该注意取蹲位休息后，直立时要特别小心，以免因脑供血不足而跌倒；

10、家人或朋友应主动为老年人提供帮助，如搀扶老年人过街道或上楼梯等；

11、行走时不要双手持物，如可借助背包等装载物件，以至少保留一只手可供必要时攀扶之用（Keep at least one hand free while walking. Use a backpack or fanny pack to carry things when possible.）；

12、行走时不要做其它事情，如经手机查阅短信，甚至编辑短信等；

13、行走时应前后摆动双上肢和避免双脚同意离开地面，以改善平衡和增加稳定性；

14、静止直立时，请保持双脚间距离与肩同宽，以增加躯干的稳定性。

Preventing falls in seniors is possible: study

NEW YORK (Reuters Health) - A fresh look at earlier studies shows there are several steps seniors can take to prevent falls - a major health concern for the world's aging population.

"The strongest evidence is for exercise that contains multiple components such as strength and balance training, whether carried out in groups or prescribed for people in their homes," Lesley Gillespie and Clare Robertson, who worked on the new research review, told Reuters Health by email.

"These programs appear to reduce the number of falls experienced by about on average 30 percent and the number of people falling by about 20 percent," they said.

About a third of Americans over 65 fall each year, resulting in nearly 20,000 deaths and more than two million emergency room visits, according to the U.S. Centers for Disease Control and Prevention.

With the right interventions, those numbers could be much lower, suggest the new findings, published Wednesday in The Cochrane Library.

Gillespie and Robertson, both at the University of Otago in Dunedin, New Zealand, and colleagues looked at 159 studies with more than 79,000 seniors who had been randomly assigned to a fall prevention program, a program not designed to decrease falls, or no intervention at all.

While some studies have suggested vitamin D supplements might help stave off falls by boosting muscle strength, the researchers found that wasn't the case, based on 16 studies with more than 29,000 participants.

Some interventions to treat vision problems, such as adjusting to new glasses, also increased the risk of falls.

Studies with thousands of participants showed exercise, including Tai Chi, effectively cut the risk of falling. So did home safety assessment and modification, especially when carried out by an occupational therapist.

A $28 BILLION PROBLEM

According to data released earlier this year by the CDC, nearly 38,000 Americans 65 and older are treated in ERs each year after tripping on a rug or a carpet. More than a third of the falls happen in the bathroom.

Ways to make your home safer include removing things like papers and books from the floor and stairs, getting rid of small rugs or taping them to the floor, improving lighting around the house, having grab bars in the bathroom and using non-slip mats in the bathtub, the agency says.

Gillespie and colleagues also found a trial including 93 participants that showed taking seniors off psychiatric medications lowered the rate of falls by two-thirds.

Another trial showed cataract surgery in women prevented falls, as did getting a pacemaker for people with a heart problem called carotid sinus hypersensitivity.

"If someone is worried about falling they should talk to their family physician or any health professional they are attending as there may be a specific cause or causes that can be addressed," the researchers added in their email.

The CDC estimates that the medical costs of falls exceed $28 billion a year. A recent study from Florida suggests a workshop-based community fall prevention program can be implemented for an average of $325 per completer over the first year and $176 the following year.

Although curbing falls might go a long way toward preventing broken bones, which can take a large toll on elderly people's health, the researchers say the exact effect on fractures is unclear.

"Our results were not particularly informative regarding fracture prevention as not all studies included this outcome," the note.

SOURCE: http://bit.ly/UKfeFR The Cochrane Library, September 12, 2012.