How CHR’s Play A Key Role in Falls / injury Prevention of Elders

August 24, 2017Community Health Representatives

AAA NACOG Conference | Flagstaff

Babak M. Nayeri, NMD, FACFE | Director, Healthy Aging

Setting the scene• Worldwide population is aging

• Impacts healthcare planning and provision

• The most problematic expression of population aging is the clinical condition of FRAILTY

• Around 10% of over 65+ have frailty

• Over 25 of over 85+ have frailty (in some studies >50%)

Formal definitions

“a state of increased vulnerability to stressors due to age‐related declines in physiologic 

reserves across neuromuscular, metabolic, and immune systems”

American Geriatric Society

Formal Consensus

“a medical syndrome with multiple causes and contributors 

that is characterised by diminished strength, endurance, and reduced 

physiological function, that increases an individual’s vulnerability for 

developing increased dependency and/or death”

J Am Med Dir Assoc 2013

Where are people likely to fall (65 + years)

Home 60%

Public Places 30%

711

792

788920

1,008

0

200

400

600

800

1000

1200

2012 2013 2014 2015 2016

Number of Deaths due to Falls among 65+ Yrs in Arizona, from 2012-2016

Fall Deaths

974Deaths14,384

Inpatient Hospitalizations

42,808Emergency Department

Visits

Chronic malnutrition 

& Sarcopenia

Loss of strength & Slowness

Reduction in physical activity

Decreased energy 

expenditure

Anorexia of aging

Frailty Cycle

Frailty• 5 meter gait 

speed• ABC Scale• Morse Scale

Comorbidity• Chronic 

disease(s)• Vision• Hearing

Disability• ADL• IADL• Nagi’s

FALL

DECREASED FUNCTIONAL

ABILITY

REDUCED ▪ MUSCLE

STRENGTH▪ BALANCE

AND GAIT▪ FLEXIBILITY

DECREASED ACTIVITY

FEAR OF FALLING

History of Falls (Previous falls)

Activities‐specific Balance Confidence (ABC) Scale

• ratings should consist of whole numbers (0‐100) for each item – Range = 0 ‐1600 – divide by 16 to get each subject's ABC score 

• 80% = high level of physical functioning • 50‐80% = moderate level of physical functioning • < 50%.= low level of physical functioning Myers AM (1998) 

• < 67% = older adults at risk for falling; predictive of future fall Lajoie Y (2004) 

Morse Fall Scale

What can be done to reduce the risk of unintentional falls?

• Maintain a regular exercise program to increase strength, balance, and coordination. Tai Chi classes are an evidence‐based method. 

• Regularly review meds with a healthcare provider, and dispose unused meds

• Have yearly eye exams. • Modify home environments to reduce hazards such as slippery floors, poor lighting, and uneven surfaces. 

Being Fit is Ageless

Arizona Falls Prevention Coalition (AFPC)

Our Calling is to Prevent Falling

AZHealthyAging.com

www.AzStopFalls.org

THANK YOUDr. Babak Michael Nayeri | Director, Healthy Aging

b.michael.nayeri@azdhs.gov |

azhealth.gov

@azdhs

facebook.com/azdhs

THANK YOUDr. Babak M. Nayeri | Director, Healthy Agingb.michael.nayeri@azdhs.gov | 602-364-0868

azhealth.gov

@azdhs

facebook.com/azdhs