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Health Matters: Providence Cedars-Sinai Tarzana Medical Center | 7 Balancing Act Older women are at high risk for falls and fractures. Here are ways to get steadier on your feet. Falls are the leading cause of injuries, some fatal, among people 65 years or older. In fact, 95% of hip fractures among older people are caused by falls, and women have a 50% greater risk of falling than men. Poor balance plays a large role. "The majority of geriatric injuries seen in the ER involve hip, wrist or spinal compression fractures from falls directly related to balance issues," says Aneet S. Toor, MD, an orthopedic surgeon at the Center for Orthopaedic Specialists at Providence Medical Institute in Tarzana. Often, people do not even realize they have balance issues, according to Dr. Toor. Although they can begin as early as age 50, the American Geriatrics Society recommends that everyone 65 or older be screened for falling risk. "As we get older, our gait pattern changes, usually due to reduced muscle strength and joint osteoarthritis," Dr. Toor explains. "Medical issues such as heart or lung conditions, diabetes, anemia, and vision or hearing impairments can all negatively impact gait and balance," he says. Dr. Toor says that older women should work with their doctors in a three-step approach to preventing falls and protecting their bones. Step 1: Get screened. Tell your doctor if you have recently fallen or experienced unsteadiness. "This helps patients become more aware of risks in their home environment, such as loose rugs, slippery floors and low lighting," he says. Step 2: Review your health and medications. Drugs or dosages may need to be changed. "We also frequently discuss obtaining DEXA bone density scans, especially if someone has experienced a fracture after a fall," Dr. Toor says. Step 3: Strengthen your bones and muscles. Vitamin D and calcium can help strengthen bones, protecting them in case of a fall. "The goal is to prevent injury from occurring in the first place, and muscle strengthening, balance training, dance classes, yoga and physical therapy can go a long way to reduce fall risk," Dr. Toor says. "Stay active within your abilities and know when balance may be an issue. If a fall happens, we can help get you back to an independent and active lifestyle." Joint Decisions Arthritis can affect women of all ages. Here's what you can do to help prevent and relieve it. If you're a young woman with chronic joint pain, you might have rheumatoid arthritis. "This is an autoimmune condition that is two to three times more common among women than men," says rheumatologist Jenny S. Oh, MD, who treats arthritis with both traditional and complementary medical approaches at Providence Cedars-Sinai Tarzana Medical Center. "It can affect women of all ages but generally sets in between 25 and 45." If you're older, you're more likely to have the more common osteoarthritis, which also affects more women than men. This is a degenerative joint disease, resulting from injury or aging, that causes stiffness and pain, especially in the hands, knees and hips. "It usually sets in after 45, and it is a leading cause of disability," Dr. Oh says. Both genetics and hormones are believed to play a part; in fact, it often sets in around perimenopause. Dr. Oh says that the following lifestyle habits can both help prevent and relieve osteoarthritis symptoms: • Maintain a healthy weight. Extra weight stresses the joints. • Exercise regularly. Weight training protects joints, and aerobic exercise helps control weight. • Prevent joint injuries. Avoid repetitive activities that put excessive stress on your joints. • Eat an anti-inflammatory diet. Follow a Mediterranean-style diet and avoid processed, high-fat foods, sugar and alcohol. • Minimize stress. Get adequate sleep. Fortunately, a wide variety of effective osteoarthritis treatments are available. "These include physical therapy, range-of-motion exercises, splints and braces, over-the-counter and prescription pain medications and joint injections," Dr. Oh says. "I also recommend several safe anti-inflammatory and joint- supportive remedies, including vitamin C, turmeric, fish oil, glucosamine, chondroitin and glutathione. But if pain still severely affects your daily life, there are several effective surgical options."

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