Sindhu: Hello everyone, and thank you for joining me today. Before we start, I would like to mention a few things about the presentation. Falls and fibromyalgia, in the elderly, are extensive topics with a lot of information to cover. I have included some general information on these two topics in the introduction section, but for most of the presentation I will focus primarily on the association between falls and fibromyalgia, and the recommendations that are specific to these patients. I will not go into too much detail about the general OT interventions or assessments for falls so that we have sufficient time to discuss what is specifically relevant in fibromyalgia.
Falls in the Elderly
The Centers for Disease for Disease and Prevention, or CDC, reported that one out of four adults, 65 years or older, falls each year, accounting for 2.8 million emergency room visits (CDC, 2016). In 2012 to 2013, unintentional injuries accounted for 85 percent of all injury deaths among adults 65 years or older in the United States, and 55 percent of these unintentional injury deaths were due to falls. Age-adjusted fall injury death rate in this age group doubled from the year 2000 to the year 2013 (CDC, 2015). Also, the fall death rate in 2012 to 2013, among adults 85 years or older, was nearly four times higher than that in people aged 75 to 84 years, and 16 times higher than that in people aged 65 to 74 years (CDC, 2015). As this shows, death increases with age, and fall injuries also have an enormous financial impact. The average hospital cost for a fall injury is about $35,000, and the cost for treating fall injuries increases with age —(Stevens, Corso, Finkelstein, & Miller, 2006).
This slide is a simple cyclical representation of how one fall leads to increased chances for another fall (Figure 1).
Figure 1. Representation of cyclical nature of falls in elderly.
We know that falls pose a serious threat to elderly individuals, both those living in the general community and to those in institutions. Besides the obvious physical injuries after a fall, the experience leaves behind an indelible memory of pain, decreased self confidence in carrying out daily tasks, a feeling of just not feeling safe, and essentially a feeling of not being in control of one's physical well-being. This naturally translates to a fear of falling, and self limiting of participation in activities that the individual was once able to do mentally and found enjoyable (Schepens, Sen, Painter, & Murphy, 2012). There is also evidence showing that fear of falling affects muscle strength, cardiovascular endurance, and agility —(Jeoung, 2015), and this physical decline in turn leads to or increases the patient's risk for another fall.
Fibromyalgia
The prevalence of fibromyalgia is estimated to be 2 percent. It is much more common in women, with a female to male ratio of seven to one, and it often runs in families. Most cases are diagnosed between 20 to 50 years of age, and the incidence rises with age (CDC, 2015).
