Health Matter: Nightlights, canes, taller furniture can all help prevent falls as we age

Q: I am worried about getting older and breaking a bone or my hip. I know it is more common in women. Is there anything I can do to prevent it? — K.D., Anderson

A: One major concern as we age is osteoporosis. Osteoporosis is defined as a disorder in which the bones become porous and brittle and often break. It is caused by loss of calcium and other minerals in the bones. The U.S. Preventive Services recommends that women older than age 65 and women younger than 65 with a family history of fractures should have a bone-density test. The bone-density test helps to identify osteoporosis and a person's risk for fractures. The information can assist you and your doctor in planning for steps you might take to improve bone density, prevent any bone loss and, if necessary, manage osteoporosis.

The risk factors for osteoporosis include diets that are low in calcium and vitamin D, lack of regular exercise or immobility, body weight (too thin), smoking, alcohol use and certain medications. Of course, there are risk factors that no one can change that may place one at higher risk. Osteoporosis is more common as we age, if we are female of Caucasian or Asian descent and if we have a family history. Because of the age factor, all women and men should be concerned about loss of bone density.

Low bone density is managed through healthy lifestyle changes that include weight-bearing activities such as walking and eating foods rich in calcium and vitamin D. If a person has been diagnosed with osteoporosis, medications are available that slow down and may reverse bone loss.

Falls are a major concern of most people as they age. The risk of falling does increase with age- related changes in our body's strength and balance, eyesight and hearing. Certain diseases such as osteoarthritis, Parkinson's, strokes and dementia can increase our risk of falling. Our choice of footwear also makes a difference. In a 2008 report by Barry and Miller, they cite the increased risk of falls when individuals are on more than three to four medications, and certain individual medications can increase the risk of falls, such as sedatives. Once a person has fallen, they tend to fear falling again. Even when a fall does not result in a broken bone, there might be other injuries that occur that require medical attention. Also noted by Barry and Miller was the greater risk of functional decline and withdrawal after falls.

An important preventive step is to ensure your environment is safe. An essential step is good lighting so you can see where you are walking. Our eyes change as we age. Depth perception might change as well. It is also important to make sure you have nothing on steps or in hallways that you might trip over. That means you might need help to clean and organize your home. Furniture might need to be rearranged to remove pieces you might trip over.

Carpets and area rugs might need no-slip strips or they might need to be tacked in placed. Consider discarding throw rugs. Some people find that chairs and sofas may need to be higher so it is easier to sit down and to get back up. You may find a cane is helpful. Talk with doctor about appropriate exercises to keep you in shape and maintain your balance.

Other considerations include using the handrails when you go up and down stairs, and do not carry things that block your vision from the steps or would require both hands. You might need to use extra care when reaching for items on higher shelves. Nightlights in the bedroom and bathroom are recommended as well. This might help if light switches are not in easy reach when you get up at night. A flashlight by the bed can be helpful as well. Grab bars may be helpful in the bathroom.

If you live alone, you might consider a medical alert system. A cordless phone that you can keep nearby can also be helpful. Cellphones are very helpful as well, if you keep it with you.

Send your health questions to Debbie Jackson, Ph.D., MN, Clemson University, 302 Sikes Hall, Clemson, S.C., 29634-5155 or email