Suggestions

Permission for Use

Falls and Hip Fractures

Reducing Falls

Decreasing Drugs and Smoking Cessation

Aggressive interventional programs designed to reduce the risk of falling through medication adjustment and exercise reduce the risk of falls by approximately 30% (Close J, 1999; Tinetti ME, 1994).

Fall risk increases with four or more medications (AGS, 2001), or when one of the drugs is known to increase fall risks, such as a CNS drug or diuretic (Ziere G, 2006).

Drugs that should be viewed as risk factors for falls include:

• Sedative-hypnotic and anxiolytic drugs (especially long-acting benzodiazepines)
• Tricyclic antidepressants
• Major tranquilizers (phenothiazines and butyrophenones)
• Antihypertensive drugs
• Cardiac medications
• Corticosteroids
• Nonsteroidal anti-inflammatory drugs
• Anticholinergic drugs
• Hypoglycemic agents
• Any medication likely to affect balance

(Fuller GF, 2000)

Smoking is a risk factor for bone density, and is thus a risk factor for falls and hip fractures (Rizer MK, 2006). The American Cancer Society's suggestions for quitting smoking include:

• using nicotine replacement therapy,
• incorporating the Health Beliefs or Stages of Change psychological models, and
• engaging in physical activity to reduce stress.

On-line sites offer support for those trying to quit or to stay quit. Many communities or hospitals have local smoking cessation groups. Using both behavioral therapy in local groups plus nicotine replacement patches produces a success rate of about 30%.