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Preventing Falls in the Elderly: Updated Guidelines

Falls are one of the most common health problems experienced by older adults and are a common cause of loss of functional independence. Studies show that unintended injuries are the fifth leading cause of death in the elderly, and falls cause about two-thirds of those injuries. Fortunately, research continues to evolve in fall prevention. In the January 13, 2011 online issue of the Journal of the American Geriatrics Society, the American Geriatrics Society (AGS) and the British Geriatric Society (BGS) updated the 2001 guideline on preventing falls in older persons based on an accumulation of new data and a literature review. Assessing Fall Risk Factors The first step in preventing falls is to determine if patients are at increased risk. The updated AGS/BGS guidelines recommend that yearly evaluations of elderly patients include questions about any recent falls as well as inquiries about balance and steadiness of gait. Balance and steadiness represent a new addition to the guidelines. These problems can result from a number of causes, so it’s important that physicians consider what may be contributing to the problem before recommending treatment. Patients should also be asked about side effects of any medications that may increase fall risk. Questions about a patient’s comfort with activities of daily living may also reveal areas of concern. If a patient has already sustained a fall, physicians should assess and treat any resulting injuries, evaluate what contributed to the fall, and then recommend interventions to prevent future falls. Take Preventive Measures to Reduce Falls In many cases, preventive measures can be taken to reduce the likelihood of falls. The appropriate course of action...

Physical Activity Recommendations for Patients With Diabetes

This Physician’s Weekly feature on physical activity recommendations for patients with diabetes was completed in cooperation with the experts at the American Diabetes Association. The CDC estimates that 25.8 million Americans have diabetes and another 79 million have prediabetes, a condition characterized by A1C, fasting glucose, or oral glucose tolerance levels that are higher than normal but not high enough to be classified as diabetes. Research has shown that regular physical activity (PA) may prevent or delay diabetes and its complications, but most people with type 2 diabetes are not physically active. “PA is central to the management and prevention of type 2 diabetes and prediabetes,” says Sheri R. Colberg, PhD, FACSM. “It helps treat associated glucose, lipid, and blood pressure control abnormalities, and aids in weight loss and weight maintenance.” She adds that medications used to control type 2 diabetes should augment lifestyle improvements rather than replace them. Help for Healthcare Providers In the December 2010 issues of Diabetes Care and Medicine & Science in Sports & Exercise, the American Diabetes Association and the American College of Sports Medicine issued guidelines on exercise for people with type 2 diabetes as a joint position statement. The recommendations, which were developed by Dr. Colberg and a panel of experts, are the first that were created jointly with the two organizations. They incorporated evidence-based data from published clinical studies and trials into the recommendations. “The presence of diabetes complications should not be used as an excuse to avoid participation in PA.” “Research has established the importance of PA to health for all individuals, but these guidelines provide specific advice for those whose diabetes may limit vigorous or other...
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