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by: Robert MacMillan MD
ast winter, while in the U.S. on our CSA show tour
my wife Tess was standing on the corner waiting
for a trafc light to change when she was suddenly
knocked down by a young cyclist using the sidewalk for his
route. Although bruised and shaken, she fortunately suf-
fered no serious injury. As snowbirds, we are always aware
of the risk of problems arising related to medical conditions
while away from home. But few of us think about the risk
of injury, especially the potentially devastating results from
a simple fall. Each year, travel medical assistance services
are involved in the case management of many clients who
have their winter vacations cut short because of an injury,
most commonly a serious fall. Most people are either
immediately repatriated by air ambulance to a Canadian
hospital, or they undergo emergency surgery locally and
are then repatriated.
Why has there been so much attention paid to this aspect
of our health as we age? The reasons include the fact that
the degree of injury and the long-term complications of
falling for individuals over the age of 65 are much more
common than in younger individuals, as well as the fact
that most falls can be prevented. The Public Health Agency
of Canada
s done extensive
work on studying this issue and has prepared a formal
report and conclusions, including how to prevent falls. They
report that falls are the most common cause of injuries
among seniors, accounting for almost 62% of injury-related
hospitalizations for trauma. The fall-related injury rate
is nine times greater among seniors than among those
less than 65 years of age and falls cause more than 90%
of all hip fractures in seniors; 20% die within a year of the
fracture. Many more are left with an inability to ever live
independently again. Numerous other agencies and health
organizations are trying to increase the awareness of risk
factors and preventive measures to reduce the risk of falls.
Risks of a medical nature that increase with advancing age
include poor gait, osteoporosis, muscle weakness, visual
impairments, medications and chronic conditions such as
Parkinson’s disease, dementia and previous stroke. People
in these situations need to pay special attention to preven-
tion. Younger people have better balance and muscle
strength and, if they do fall, are more likely to recover.
Their bones are stronger and less likely to fracture. Active
daily exercise is one of the best ways to increase muscle
Watching your Step