Age-related physical and physiologic changes and comorbidities in older people: Association with falls

Abstract

Several age-related changes that increase fall risk will be described. Changes in vision can result in impaired accuracy and sense of dimension. Changes in the vestibular system increase the response time to positional changes in older persons. Age-related muscle loss known as sarcopenia can lead to muscle weakness. The aging brain has a slower reaction time due to changes in intracerebral blood flow, neurotransmitter levels, cognitive impairment, and reductions in the neuron population. The heart and blood vessels become stiffer and the heart fills with blood more slowly. Stiffer arteries are less able to expand and results in increases in blood pressure. Orthostatic hypotension can be the result of the blunted vasoconstriction of stiffer blood vessels coupled with decreases in cardiac output. Medical comorbidities such as diabetes mellitus, dementia, Parkinson’s disease, cerebrovascular disease, congestive heart failure, and chronic kidney disease can contribute to increased fall risk. Some comorbidities can involve changes in muscle mass (secondary sarcopenia) and calciotropic hormones leading to weaker muscles and bones.