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Care of the Older Person



Older persons are more likely to have impaired physiological reserves and are also more likely to suffer from chronic medical conditions such as hypertension, diabetes mellitus and heart disorders. These conditions, together with the impact of acute illnesses and adverse effects arising from polypharmacy, can result in progressive weakness and impaired mobility. Worsening mobility, especially if it is of recent onset, can also be a portent of an underlying medical problem that needs to be assessed and addressed. Some of the common causes of worsening mobility are amenable to treatment and can potentially be cured.

The incidence of falls increases with age and studies have shown that as much as one third of healthy community-dwelling older persons fall every year. It is also known that older persons who have had a first fall during the preceding year are more likely to fall again.

Falls in older persons are associated with serious physical injury in less than 10% of the time. Examples of such serious injuries include fractures and serious head injuries. However, more than 50% of older fallers can be psychologically traumatized by their falls and develop a state that is often referred to as "fear of falling". Fear of falling can then lead to a progressive decline in mobility, together with its associated complications (such as pressure sores, incontinence, constipation and infections), depression and social isolation.

As in the case of many other "geriatric syndromes", falls can arise from an interplay of many conditions and environmental circumstances. These may include acute illnesses such as infections, impaired cognition, poor vision, medication side effects or even poor footwear. Occasionally, falls may arise because of a general state of frailty that has arisen because of multiple co-existent chronic conditions.

Studies have shown that older persons who have had recurrent falls may benefit from thorough assessment by suitably trained personnel and subsequent targeted interventions.

If you or your relatives have had recurrent falls, you may benefit from an assessment by your doctor.

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Care of the Older Person


About Our Doctor


Dr Sitoh Yih Yiow is a consultant geriatrician who graduated from the National University of Singapore in 1991. He obtained his Membership of the Royal College of Physicians of the United Kingdom in 1996 and was awarded a Higher Manpower Development Programme (HMDP) fellowship by the Ministry of Health... Read more about our doctor