Dementia increases risk of falling: How to reduce the threat

Dementia increases risk of falling: How to reduce the threat

Anyone with dementia not only deals with cognitive decline, but also faces the increased risk of falling.  People with dementia are four to five times more likely to fall than older people who do not have cognitive impairment. In addition, those with dementia who fall are three times more likely to risk sustaining a fracture and are five times more likely to be hospitalized or live in a long-term care setting than for cognitively well people.


With an aging population, both dementia and fall-related injury pose a major health risk. Why do those with dementia have an increased risk of falling and how can this threat to their health be reduced?

·      Why cognitive decline increases the risk of falling


There are several reasons why someone with mild to more severe dementia are considered a ‘fall risk:’

·      Medications – A term called polypharmacy is when a person is taking too many medications – a common problem for older adults. Over 76 percent of American age 60 and older take two or more prescription drugs on a regular basis, according to the Centers for Disease Control and Prevention (CDC) and 37 percent take five or more.  Polypharmacy increases the risk for falls in several ways: increased risk for inappropriate medications, increased risk for side effects and interaction between medications, and compliance to prescription might decrease with increased number of prescribed medications. Also certain drugs that affect the central nervous system – antidepressants, hypnotics and opioids – have long topped the list of pharmaceuticals that may increase fall risk, along with diuretics, constipation medications and NSAIDs. A doctor should always review the medications anyone with dementia is taking. Find out if there are ways to minimized of any of the drugs that can further impair cognition and reaction time.

·      Vision and hearing problems – Older people who have diminished vision and hearing can be at a disadvantage in risk of falling. Difficulty seeing may increase the risk of falls while research has also linked hearing loss to a higher risk of falling.

·      Homes that are not “fall-proof” – The majority of falls happen in people’s homes. Area rugs, extension cords, poorly lighted hallways, stairwells, and bathrooms are common culprits making homes hazardous for those with dementia and risk of falling.

·      Safety tips for preventing falls 

To maintain protect those with dementia from the risk of falling, it begins by a thorough inspection of their home. There are many ways to make sure your home is safe and to recognize potential hazards that could contribute to a fall.  Add to this list a review of their medications with their doctor, regular vision and hearing exams, and working on improving balance.

Here are simple steps to prevent falls in those with dementia or anyone:

1.     Floor and rugs

·      Clean floors of clutter and any items you can easily trip over.

·      Check floor boards for evenness.

·      Make sure area rugs are secured to floors with tacks, non-skid pads or double-sided tape.

·      Wipe up all spills immediately.

·      Use non-skid floor wax.

2.     Kitchen

·      Have a step stool that has a bar at the top to hold onto.

·      Keep items used frequently such as dishes and food items within easy reach.

 3.     Bathroom 

·      Have easy access into and out of both the tub and shower.

·      Use non-slip mats in both the bath and shower.

·      Add grab bars to your tub and shower walls or next to the toilet.

·      Make sure bath mats are secure with non-slip, double-sided rug tape.

·      Install adjustable height shower heads.

·      Remove soap build-up in tub or shower regularly.

·      Place a bench within the shower to be able to sit down if necessary. 

4.     Stairways 

·      Keep stairways well-lit and free of clutter on the steps.

·      Place carpeting or non-skid pads on each step.

5.     Lighting

·      Place nightlights in hallways, bedrooms, bathrooms, and stairways.

·      Install light switches at the top and bottom of stairs.

·      Have a lamp and telephone on a nightstand near your bed.

·      Add solar-powered lighting around sidewalks leading to your house. 

6.     Safety in general

·      Wearing rubber-soled shoes has better traction than wearing socks in the house.

·      Be careful around pets as they can be a common cause of falls.  Look around yourself before making sudden moves to avoid  tripping over them,

·      Make yearly trips to the eye doctor to keep your vision sharp.

·      Some medications have a side effect of dizziness.  Ask your doctor about this and ask whether a different medication can be prescribed.

·      Work on improving your balance by doing physical activities such as yoga, Pilates, or tai chi.