Why more old people are dying after falls

I want to push back on part of the message. I agree routine prescribing is a problem which can lie at the heart of what does ultimately kill older people. But, some problems (like persisting interrupted sleep) aren't actually amenable to simple sleep hygiene methods in some people. The drugs, with side effects, help when it turns out your idiopathic sleep problem isn't resolving with CBT. I am lucky my sleep irregularity is a function of my work (jetlag travel) and play (early starts for rowing) -my partner would love a regular sleep, but without some assistance, does not get there and she has been assessed repeatedly for the non-drug pathways. They just don't work for her.

I think the problem is, we're exposed to more people with brittle bones, being encouraged to be active, which is of course GOOD for their bones, but also increases the risk. In times past, we'd have wrapped them in a tartan blanket and pushed them to the park in a wheelchair. Now, we encourage a more risk-taking approach, and so the cohort who suffer life affecting falls rise. In times past, that cohort probably had died earlier.

Middle ear problems, balance, massive in this. as a (young!) 64 year old I notice my pilates classes emphasise balance work alongside core strength. The physios are explicit: if they can key people to keep balance, work on joint issues affecting stability, even help them "fall more safely" it's a better outcome than just working core strength and weight bearing exercise, but leaving balance issues unattended. And indeed the drugs probably are part of the problem. I have something which is akin to POTS in that my (drug)managed Hypertension leaves me exposed to dizzy spells standing up suddenly. I'm not going to stop the BP meds, I have to learn to cope with the change in BP when I change posture.

Another part of the problem is the emergence of newer infections like covid, which if they manifest as middle ear problems means BPPV. I've had a lot of my older cohort of friends complain since they started getting the regular cycle of flu, RSV, covid, they've had vertigo off-and-on.

Proprioception exercises are some of the most important things you can do to minimally address issues around balancing, and many of them are low enough intensity that they can be performed while watching TV.

I'll often perch on one foot on a bosu ball for a few minutes at a time. You can ramp up the difficulty by closing your eyes which can be surprisingly challenging the first time you try it. Makes following the movie really hard. :)

https://pmc.ncbi.nlm.nih.gov/articles/PMC4309156