In January, we wrote about updated (2010) clinical practice fall guidelines from the American Geriatric Society/British Geriatric Society. The article,  Summary of the Updated American Geriatrics Society/British Geriatrics Society Clinical Practice Guideline for Prevention of Falls in Older Persons, is available online  here.

Two notable changes from the 2001 guidelines, include:

• The recommendation of Tai Chi as an effective way to prevent falls;
• The recommendation that doctors review medication use by all older persons, with an eye toward reducing use of drugs that increase risk for falling.

An essay by Karen Stabiner, New Advice on Preventing Falls,  in The New Old Age, Caring and  Coping, a blog of the New York Times (February 17, 2010),  speaks to these two changes. A few excerpts from the essay are below.

• "The earlier guidelines did not single out any particular exercise regimen and endorsed prescription reviews only for patients taking more than four medications."
• "Exercise is essential for any older person who can manage it, according to Dr. Mary Tinetti of the Yale University School of Medicine, a chairwoman of the panel that issued the new guidelines. Tai chi gets the nod because several trials have suggested that it seems to help reduce the risk of falling, she said, although it is possible that other forms of balance training work just as well."
• "The evidence is strongest that medications that affect the brain - these include antidepressants, sleep medications and medications for anxiety - increase the risk of falling," said Dr. Tinetti. "There is also a suggestion, not yet proven, that narcotics and some blood pressure medications may increase the risk of falls, as well."