Adults over 65 years are more likely to be affected by sarcopenia. Sarcopenia refers to an age- related loss of muscle which results in a loss of strength and muscle function. The risk of sarcopenia increases with age.

Why are older adults more prone to falls?

Sarcopenia is caused by a number of factors, including:

• Malnutrition (from a lack of energy and protein intake)
  Ageing (due to breakdown of muscle fibres)
• Immobility (not using the muscles)
• Injury
• Chronic disease and inflammation

Development of sarcopenia is associated with an increased risk of falls, fracture and mortality. Older adults with sarcopenia have a 60% chance of falls and a 70% chance of fractures (Yeung S et al. 2019).

For those over 65 years of age, there is also an increased risk of hospitalisation following a fall.

What are some ways we can reduce the risk of falls and fractures?

By focusing on bone and muscle health through:

• Nutrition
• Early identification of sarcopenia and malnutrition through screening and assessment
• Resistance exercise

Who should we be screening for nutritional status and why?

Anyone 65 years or older and adults with a history of falls should be screened for malnutrition.

Malnutrition can be screened using a validated tool such as:

What is the management for those at risk of malnutrition?

Early referral to a Dietitian for assessment and tailored nutrition intervention.

Nutritional intervention includes:

• Increasing protein intake to stimulate muscle growth/maintenance e.g meat, fish, chicken, eggs, legumes, pulses and dairy.
• Increasing calcium intake for bone health e.g cheese, yoghurt, milk, seafood (particularly with soft edible bones) and green leafy vegetables.
• Increasing vitamin D for bone health and muscle strength e.g eggs, oily fish, fortified products or through supplementation.
• Increasing total energy(kcals/KJ) to prevent muscle breakdown

Practical ways to prevent falls and fractures?

• Reduce the risk of sarcopenia through early identification (screening) and treatment
• Early referral to a Dietitian for detailed assessment and management (pre and post fall, or residents returning from hospital)
• Assist older adults to meet their nutritional requirements by encouraging high protein, high energy foods.
• Refer residents to a physiotherapist for a more personalised strength and mobility plan.

Nutrition plays an important role in muscle and bone health and therefore, falls prevention and management. It is important to include a Food Solutions Dietitian in your falls management pathways.