Fall Prevention in a 55-Year-Old Woman After Garden Slip
Increase dietary calcium is the most appropriate intervention to reduce future fall risk in this 55-year-old woman who sustained a blunt abdominal injury from a garden fall. 1
Primary Recommendation: Calcium and Bone Health
For a woman in this age group who has experienced a fall, the priority is preventing fragility fractures through optimization of bone health. 1 While the question presents this as a fall prevention scenario, the critical outcome to address is the morbidity from potential future fractures, not just preventing the fall itself.
- Adequate dietary calcium intake is essential for bone health and should be maintained at country-specific recommended levels, which favorably impacts bone density and fracture risk. 1
- Women approaching menopause and beyond are at increased risk for osteoporosis, making calcium optimization crucial even after a single fall event. 1
- This intervention directly addresses the underlying fragility that makes falls dangerous, reducing the severity of injury if future falls occur. 1
Why Other Options Are Less Appropriate
Weight reduction (Option B) lacks evidence support in this context:
- No weight was mentioned, making this recommendation inappropriate without assessment. 1
- Weight reduction alone has not been shown to reduce fall rates in community-dwelling older adults. 1
Avoiding contact sports (Option C) is not evidence-based:
- The fall occurred during routine daily activity (gardening), not during sports participation. 1
- Restricting physical activity is counterproductive - regular exercise including weight-bearing impact exercise and resistance training actually promotes strong bones and improves physical performance. 1
- Exercise interventions incorporating balance and functional training reduce fall rates rather than increase them. 1
Comprehensive Fall Risk Management
While calcium is the best answer among the options provided, a complete approach for a 55-year-old woman with a fall history should include:
- Multifactorial falls risk assessment focusing on history of falls within the past 12 months, fear of falling, and feeling unsteady while walking or standing. 1
- Multicomponent exercise programs incorporating dynamic weight-bearing, strength training, and balance training undertaken 2-3 days per week for at least 10 weeks. 1
- Home hazard assessment and modification as part of a comprehensive multimodal approach, though not as a standalone intervention. 1, 2
- Medication review if taking 4 or more medications or any psychotropic drugs. 3, 4
Critical Pitfall to Avoid
Do not restrict physical activity or recommend avoiding exercise - this is the opposite of evidence-based care. 1 The most effective fall prevention strategies include regular long-term exercise with balance and functional training, not activity restriction. 1, 5