Elizabeth and the hypothesis of the fall, the geriatrician: “Final stage for many elderly”

“They are like a crystal vase, it takes very little and it shatters”, explains Marco Trabucchi. “Prevention is crucial, because they are often not aware of it and if they are well they are prone to risk”

“It is like with a very delicate crystal vase”: even when it seems perfectly intact, to break it “there is no need to throw it at 10 meters; sometimes a person who inadvertently passes by and gives it a light push is enough, and he shatters. ” While in the Italian chronicles the indiscretion that Queen Elizabeth may have died after an accidental fall in the Scottish castle of Balmoral, Marco Trabucchi, scientific director of the Geriatric Research Group of Brescia and president of the Italian Association of Psychogeriatrics, describes thus to Adnkronos Salute the effect that the most banal of domestic accidents can produce in the elderly. “Often – he explains – it is the final stage of a story that had been kept in balance for a long time”.

“I certainly do not want to make a diagnosis on the death of Elizabeth II”, the specialist is keen to premise. But commenting on the hypothesis, Trabucchi confirms that “falls are today one of the main problems of geriatric medicine. One of the most serious, often the fatal event. This is why we doctors say that the falls of the elderly must be prevented with absolute determination, as one of the fundamental objectives of assistance of the frail elderly in the most advanced ages. Over the age of ninety, when a person has for example a heart disease, cardiorespiratory difficulties, perhaps a tumor – analyzes the expert always speaking in general terms – the Fall prevention is the most important aspect, precisely because falling can mean breaking a very difficult and delicate balance, which however existed and lasted for some time “.

In a very elderly person, slipping or stumbling can accelerate death because especially in these cases “the fall can cause not only a trauma or a fracture – Trabucchi specifies – but cause complications such as general cardiac decompensation, often a sudden and very violent inflammatory state. All situations that can quickly lead to death “.

“The real problem is that often one is not aware of this – the geriatrician remarks – So the elderly person himself, if he is cognitively healthy, must be warned. He must be made to understand that falling would be the worst thing. You have to convince him to ask for help. at night if he gets up, or during the day even when he has to walk just a few steps. He must be told to wait, to be accompanied by someone, never to try to overcome himself. This is the problem because even a 90-95 year old, if he feels well, he is inclined to take risks and it is really a danger “, warns Trabucchi.

A warning supported by the data reported online by the Higher Institute of Health on the basis of the Silver Steps surveillance system. It emerges that in the 2017-2020 four-year period, 8% of respondents declared that they had fallen in the 30 days prior to the interview and in 18% of cases it was necessary to be hospitalized for at least one day. Falls occur mostly inside the home (63%); less frequently on the street (21%), in the garden (11%) or elsewhere (6%). However, we read on the ISS ‘Epicenter’ portal, “the home is not perceived by the elderly as a place at risk of falls: only one in three respondents consider it a place where the probability of having an injury is high or very high “, although” this awareness grows with age (44% among the over 85s) and is higher among women (39% versus 26% among men) “.

Falls – it still appears from the survey – are more frequent with advancing age (7% of 65-74 year olds and 12% of over 85 year olds report them) and among women (90% against 7% in men ). However, only about 4 out of 10 respondents are afraid of falling, since it rises to 7 out of 10 among those who have already experienced this event. In the home environment, overall only 68% resort to the use of at least one anti-fall device including the mat in the bath or shower, grab bars or seats; the remaining 32% do not use them, even if the use of these aids is more frequent with increasing age (81% among the over 85) and among women (72%).

Finally, the ISS points out, “the attention of health workers to the problem of falls among the elderly still seems too low. Only 16% of the interviewees declared that they received, in the 12 months preceding the interview, the advice from the doctor or from a healthcare professional on how to avoid falls. “