A Team Approach to Age-Related Fall Prevention
For 41 years, Evergreen Speech & Hearing Clinic has offered comprehensive vestibular evaluations to the Eastside population. Our advanced diagnostic equipment, expert audiologists and long history of working with otolaryngologists, physical therapists and others in the area have helped locate, identify and treat patients’ underlying pathology.
Dizziness, Vertigo and Falls: CDC Analysis
According to The Centers for Disease Control and Prevention (CDC), our aging population shows a significant increase in falls. The CDC reports that all adults over the age of 65 are at risk for a fall. More than eight million falls required medical attention and more than 32,000 were fatal. The rise in falls in adults 65 or older is something the healthcare industry must address holistically. The CDC has developed a site that providers can use to access guidelines on preventing falls (www.cdc.gov/STEADI). Evergreen Speech and Hearing Clinic is committed to working with our peers to prevent more falls in our area.
The Balance System and Testing at ESHC
The human balance system incorporates sensory information from the vestibular end-organ as well as the visual and proprioceptive systems. To assess imbalance symptoms, ESHC uses a variety of tests, including Videonystagmography (VNG), which evaluates the patient’s vestibular ocular motor function, Video Head Impulse Test (vHIT), Sensory Organizational Performance Tests and Vestibular Evoked Myogenic Potential Tests.
These tests access all six vestibular semicircular canal labyrinths, superior and inferior vestibular nerves, otolith and saccular function. Together, the testing gives our patients and us a comprehensive picture of their vestibular health and can help locate the origin of their imbalance. From there, we can help manage their symptoms.
Preventing Falls: Vestibular Testing & Beyond
Fall risk factors come in two categories: intrinsic and extrinsic. Intrinsic risk factors are physical conditions that may contribute to falls, such as:
- Advanced age
- Previous falls
- Muscle weakness
- Gait & balance problems
- Poor vision
- Postural hypotension
- Chronic conditions, including arthritis, stroke, incontinence, diabetes, Parkinson’s and dementia.
- Fear of falling
Extrinsic risk factors include medications and environmental features (or lack thereof) present as hazards in the patient’s home, workplace and other settings. Some extrinsic risks are:
- Lack of stair handrails
- Poor stair design
- Lack of bathroom grab bars
- Dim lighting or glare
- Obstacles & tripping hazards
- Slippery or uneven surfaces
- Psychoactive medications
- Improper use of an assistive device
(Richard Gans, Ph.D., The American Institute of Balance)
There are many compelling reasons to refer patients to audiology at ESHC:
- The average patient sees 4.5 physicians before a correct diagnosis is made.
- According to John Hopkins, 85% of dizziness and vertigo is caused by physiological dysfunction within the inner ear.
- 25% of people suffering from migraines report vertigo as an aurally induced symptom (American Academy of Neurology).
- Research at Emory University has shown that older adults do not fall solely as a function of age.
Referrals & Care by Symptom
Balance disorders and falls have many causes, which means that patients need to address different risk factors with various providers. Patients who are experiencing the following issues should consult the following practice types:
- Vestibular disorders and poor balance: ENT, audiology & PT
- Vitamin D deficiency: Primary care/lab
- Medication linked to falls: Patient’s current prescriber
- Postural hypotension: Neurology
- Vision Impairment: Optometry
- Foot or ankle disorder: Podiatry
- Home hazards: Primary care and family assistance