The prescription for reducing dangerous falls

While falling may not traditionally be thought of as a disease, a lot of research suggests that like any disease, there are risk factors for falling: patients on multiple medications or those with visual difficulty and balance problems are more likely to fall. And there are consequences - nearly 10 percent of all emergency department visits are because of falls, with older people suffering from hip fractures or head trauma. But can patients who are prone to falls be identified and treated before the fall occurs - the way a disease can be caught before it progresses? Researchers, including Dr. Mary Tinetti from Yale University, sought to answer this question. After training physicians, nurses, and other medical staff in fall prevention techniques - such as cutting down on the number of medications the elderly take or addressing gait problems, researchers found that patients seen by trained staff were 11 percent less likely to fall. "We've known for a while now that falls have poor outcomes in the elderly - the next step is applying prevention to real practice," says Tinetti.

BOTTOM LINE: Helping older people improve their balance and keeping a careful watch on their medications can reduce the number of devastating falls.

CAUTIONS: Researchers chose clinics in certain areas for training rather than randomly choosing areas to survey, so the results may not be the same elsewhere.

WHAT'S NEXT: Researchers are continuing to find ways to make fall prevention less theoretical and more practical.

WHERE TO FIND IT: The New England Journal of Medicine, July 16.

SUSHRUT JANGI

Among the weirdest of global warming's possible consequences: one Dallas researcher predicts it will give more Americans kidney stones. Currently, the warmer parts of the country have higher rates of kidney stones than colder parts, largely, researchers think, because in hotter climates, people generally urinate less - because of low fluid intake or sweating - allowing salts to crystallize in the kidney. Tom Brikowski of the University of Texas at Dallas and colleagues estimate that a 5- to 7-degree temperature rise because of climate change would yield a 30 percent increased incidence of kidney stones in such places as Texas and California and a 10 percent rise nationwide. "This in itself is not a crisis," Brikowski said, "but it adds to the pile of inconveniences that may make people want to change their carbon dioxide footprint."

BOTTOM LINE: Global warming may to lead to more than 1 million new cases of kidney stones in the United States by 2050, as the warmer temperatures lead to more fluid loss - a risk factor for kidney stones. Drinking lots of water and monitoring urine color for signs of dehydration can help reduce the risk.

CAUTIONS: The researchers used conservative temperature increase estimates so the risk of kidney stones may be higher. The study used estimates to create two temperature-response models and the specific link between temperature increase and the rise in kidney stones is still unknown.

WHAT'S NEXT: The researchers plan to do a more precise temperature response model with kidney stone data and then do a prospective study using this model.

WHERE TO FIND IT: Proceedings of the National Academy of Sciences, July 15

DINA FINE MARON