FINDING BALANCE ALGORITHM
All medications including prescription, over-the counter, vitamins, minerals, herbs and other natural health products, should be reviewed by a doctor, nurse practitioner, and/or pharmacist annually. Some drugs alone or in combination with other ones can increase the risk of falling.
As people age, the way some medications work and/or are handled by the body can change and increase the risk of falling. Tools are available to assist older adults keep track of their medications and note questions to ask their healthcare professional. (See Resources for Clients below).
Older clients on 4 or more prescription medications have a higher risk of falling than those taking fewer medications. However, the number is perhaps less important than considering the type, duration and dosage. Certain types of medications are associated with a higher risk of falling.
High risk medications include sedative-hypnotics (e.g., benzodiazepines and other sleeping pills), antidepressants (e.g., tricyclic antidepressants, selective serotonin reuptake inhibitors), neuroleptics (also known as antipsychotics or tranquilizers),
Vitamin D and Calcium
Older adults may reduce their risk for falls and fractures by optimizing bone health. Eating a balanced diet that includes all 4 food groups helps keep bones strong and prevent fractures. Taking a vitamin D supplement and consuming the recommended amount of calcium each day can increase bone and muscle strength, reducing the risk of falls and fractures from falls.
Osteoporosis Canada advises that all healthy adults age 19 to 69 years take a daily vitamin D supplement of 400 IU year round as it is difficult to get enough vitamin D from diet alone. Osteoporosis Canada advises adults over 50 who are at risk of vitamin D deficiency take 800-2000 IU of vitamin D daily as a supplement. Individuals should not take more than 2,000 IU vitamin D supplement without checking with a medical practitioner. Remember to add together the vitamin D from all sources.
For adults over 50 years Osteoporosis Canada recommends a total intake of 1200 mg of calcium daily from food and supplements combined. Taking more calcium than the recommended amount is not better. Recent evidence points to possible health risks from taking high dose calcium supplements, so always check with a healthcare provider for advice on calcium supplements.
Individuals should be referred to their physician or healthcare provider to find out if they are at risk of vitamin D deficiency or osteoporosis. The Daily Recommended Intake (DRI) of nutrients is aimed at a generally healthy population - they are not therapeutic recommendations for treatment of medical conditions. It is important that those individuals at risk for osteoporosis, or who are under treatment for this disease, have their nutritional intake evaluated by a Registered Dietitian.
As people age, their bodies do not break down alcohol as efficiently. It is best to minimize the use of alcohol as even a small amount can increase the risk of falling.
The combination of alcohol and a sedating medication like a sleeping pill is particularly risky. If older adults are unsure about whether it is safe to drink alcohol with their medication, they should speak to their doctor, pharmacist or nurse practitioner.