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Falls in the Elderly and in Persons with Chronic Disease

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Complications in Dialysis

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Abstract

Falls are common in the elderly and in patients with chronic kidney disease. They are particularly common among elderly dialysis patients. The systemic diseases accompanying dialysis heighten the risk, and the presence of existing bone disease makes fractures more likely. Falls are also likely to occur at the end of the dialysis treatment when patients have postural hypotension.

Persons likely to fall can be separated into three large categories—(1) those with cognitive decline, frailty, or a history of a stroke, (2) patients on medications that decrease alertness, blood sugar, or blood pressure, (3) persons with chronic diseases that may have accompanying disorders in gait, muscle strength, balance, or vision. Falls can either be related to an underlying clinical disorder or can be mechanical, the result of slipping or suddenly losing one’s balance.

Efforts to prevent falls include assessing the patient and determining the risk of falling, and identifying and attempting to correct underlying problems. In many instances, the use of an assistive device will be required. In other circumstances, balance or resistance exercises may be beneficial. Patients with cognitive disorders, strokes, or who are frail will need more supervision. Fall-proofing one’s environment may help prevent unnecessary trips and reduce the risk of falls.

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  1. Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA

    Stephen Z. Fadem

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  1. Section of Nephrology, Baylor College of Medicine, Houston, TX, USA

    Stephen Z. Fadem

  2. Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil

    José A. Moura-Neto

  3. Salisbury, VT, USA

    Thomas A. Golper

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Fadem, S.Z. (2023). Falls in the Elderly and in Persons with Chronic Disease. In: Fadem, S.Z., Moura-Neto, J.A., Golper, T.A. (eds) Complications in Dialysis. Springer, Cham. https://doi.org/10.1007/978-3-031-44557-6_19

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