Falls, the leading cause of accidental deaths at home, according to a new study, may have more to do with a person's health than with physical hazards such as steep stairs and slippery tubs.
"People tend to think it was just one thing that made them fall," said Dorothy I. Baker, a researcher with the Yale University School of Public Health who studies falls and fall-related injuries. They generally blame not their physical condition but "environmental risks -- dip in the lawn, caught my heel, didn't see the last step," she said.
In fact, Baker continued, a fall typically "isn't just one issue. It's a conspiracy of things coming together at once." Frail bones, poor eyesight, bad balance, weak muscles and slow reflexes all contribute to falls, researchers believe.
About 6,000 people a year die from accidental falls in the home, according to a report released this week by the Home Safety Council, a nonprofit group. Of Americans who die from falls, three-quarters are older than 65.
Falls are also the chief cause of hip fractures, which cost many seniors their independence because recuperation is at best slow and challenging. One in five older people who fractures a hip dies within a year, according to the Centers for Disease Control and Prevention in Atlanta, mostly from complications arising from being bedridden.
The body's ability to handle a fall shrinks substantially with age, said Joseph D. Zuckerman, who heads the education committee of the American Association of Orthopaedic Surgeons. In addition, drug interactions and low blood pressure may cause dizziness or fainting that trigger a fall. Weak leg muscles may cause people to totter, and poor eyesight can cause missteps.
While experts say that having banisters on both sides of stairs, taking up throw rugs and wearing shoes rather than slippers or socks help prevent falls, they advocate a combination of home fixes and attentiveness to personal health:
* Exercise. Researchers favor lower-body exercises and balance-control regimens such as tai chi or ankle conditioning. Walking helps, too.
* Medication reviews. Judy Stevens, a CDC specialist in falls, suggests asking a doctor or pharmacist to review medications for risky drug interactions and ensure dosages are right. Drug interactions and improper dosage can seriously affect balance and alertness.
* Eye exams. The CDC says vision problems can increase the risk of falling by as much as 60 percent, and so doctors recommend regular eye exams, especially for older adults.
* Medical exams. Some chronic conditions and illnesses, such as diabetes and Parkinson's disease, can affect balance and increase the likelihood of fainting. A history of stroke can increase a person's chance of falling. Post-fall checkups are important, too, because people who have fallen before are more likely to fall again.
* Home modification. Adding stair railings and "grab bars" next to toilets and bathtubs, taping down or taking up loose carpets, raising low sofas and beds, keeping electrical cords from underfoot and laying non-slip mats or decals in tubs and showers all help.