Before the slip and the fall

FALLS IN the home are often a tragic consequence of the aging process, as explained by Alice Dembner in a Globe series last month. Twenty-nine percent of older people who break a hip, mostly from falls, die within a year. This epidemic ought to be the occasion for a nationwide public health response, and there are encouraging signs that Massachusetts will begin a prevention campaign. But that will take months to unfold, and before then, elderly people can protect themselves in at least five ways:

Take Vitamin D. But not just any Vitamin D, said Dr. Heike A. Bischoff-Ferrari, lead author of a study that confirmed the value of Cholecalciferol, also called Vitamin D3, in preventing falls. When taken over time, it strengthens the bones and muscles so that the risk of falling for older women is reduced by 46 percent. Vitamin D3 is different from Vitamin D2, which is found in most multivitamin supplements. It needs to be bought separately. Bischoff-Ferrari, in a telephone interview last week, recommended a dose of at least 800 units a day.

Get rid of scatter rugs. Anything that's loose on the floor is a danger, nothing more so than throw rugs, which look innocuous, and perhaps have been in the house for decades. But it's easy to slip on one of them. Bischoff-Ferrari considers them an unnecessary peril for anyone worried about falling.

Beware the bathroom. An elderly person could trip while using the toilet or entering the bath or shower stall. Bischoff-Ferrari recommends hand grips strategically located to minimize the danger.

Watch the medicines. Some prescription drugs can inadvertently increase the risk of falls. Bischoff-Ferrari recommends a visit to the doctor to make sure that the drugs, whether singly or in combination, do not pose a risk. She was especially concerned about side effects of benzodiazepines, a class of medicine used to control anxiety attacks.

Take a walk. And finally that old standby -- exercise. It need not be done in a fancy and expensive fitness center. A daily walk will help, Bischof-Ferrari said. According to the Harvard-Brigham and Women's Nurses Health Study, older women who walked four hours a week reduced their danger of hip fracture by 40 percent.

In response to the Globe series, Senator Richard Moore, Democrat of Uxbridge, has filed legislation that would commit the state to a public health campaign to prevent falls and improve treatment of hip fractures. This is a sound idea but would take a while to implement. Scores of people are admitted to hospitals for falls every day in Massachusetts (a 2004 study put the annual figure at 25,000). Simple, relatively low-cost steps taken now can minimize this number and relieve a danger that brings fear, infirmity, and premature death to the nation's elders.