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  • Dr Stephanie Matinpour, PharmD, CGP, FASCP

Managing Medications & Fall Risk


Older adults, as a group, are at higher risk of falling than younger individuals, and are more likely to sustain an injury as the result of a fall. Falls are not only associated with greater morbidity and mortality in the older population, but are also linked to reduced overall functioning and early admission to long-term care facilities. Falls are serious health issues for seniors, as they are associated with a decrease quality of life and independence. Many risk factors often lead to a senior falling, this presents a challenge to health care providers and caregivers to pinpoint the exact cause. Medications are one of the most easily modifiable risk factors and should be prioritized to decrease the risk of falling in the home setting.

Vegans, alcohol-dependent individuals, and patients with malabsorption syndromes are at high risk of inadequate vitamin intake.

Sunlight exposure is the primary source of vitamin D; limited amounts of vitamin D are obtained from dietary sources because few foods are naturally rich in vitamin D. Dairy products, many of which are fortified with vitamin D, are the most common food sources.

The National Osteoporosis Foundation currently recommends 800–1000 international units of vitamin D per day for adults 50 and older. For optimal health, the recommended calcium intake for adults 51 years and older is 1200 mg of elemental calcium daily.

Another issue we see in the geriatric population is related to postural hypotension (or orthostatic hypotension) is when your blood pressure drops when you go from lying down to sitting up or from sitting to standing. When your blood pressure drops, less blood can go to your organs and muscles. This can make you likely to fall. This can happen regardless of whether you are currently on medications that lower your blood pressure.

What can I do to manage my postural hypotension?

• Tell your healthcare provider about any symptoms.

• Ask if any of your medicines should be reduced or stopped.

• Get out of bed slowly. First sit up, then sit on the side of the bed, then stand up.

• Take your time when changing position, such as when getting up from a chair.

• Try to sit down when washing, showering, dressing or working in the kitchen.

• Exercise gently before getting up (move your feet up and down or after standing (march in place).

• Make sure you have something to hold onto when you stand up.

• Do not walk if you feel dizzy.

• Drink 6-8 glasses of water or low-calorie drinks each day, unless you have been told to limit your fluid intake.

• Avoid taking very hot baths or showers.

• Try sleeping with extra pillows to raise your head.

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