Morning Coffee and Falling What’s the Risk?

I'm often asked by my older patients, especially those at fall risk, if it's okay to drink coffee. They’ve heard that coffee (specifically caffeine) may not be good for older bodies, causing among other health problems, stumbles and falls. Their unease about coffee is reasonable, since older people love their coffee! They drink more coffee than any other age group (sipping at least 1 cup per day).

?For those short on time, here’s the bottom line: Drinking 1 to 4 cups of coffee per day is good for one’s health, regardless of age, (increasing alertness, energy and ability to concentrate) and, best of all, coffee is protective against falling. But drinking too much coffee can have negative effects?(anxiety, restlessness, insomnia, rapid heart rate, etc.) and can significantly increase fall risk. For those staying on, while enjoying their morning cup of coffee, I’ll continue.

Coffee Benefits

There are several well researched studies showing that habitual or routine coffee consumption (2-4?cups per day) ?is associated with decreased fall risk, including lower risk of injurious falls. Both men and women share in this benefit. The protective effects of caffeine include:

?Increased alertness, including improved cognitive functions. This is of great interest in reducing dementia (Alzheimer's disease), a major health problem in an aging population, without a cure at present. Beginning in midlife, routine coffee drinking can reduce the risk of dementia by 65%.

?Reduced risk of chronic conditions, such as Parkinson's disease, diabetes (type 2),?cardiovascular disease, sarcopenia (a loss of muscle mass, strength and function) and depression—all of which are strong risk factors for falls.

?Reduced heart failure is another positive effect of moderate coffee drinking. Individuals, including older people, who consumed 1 to 4 cups daily are 20% less likely to be saddled with cardiovascular disease.

Warning: Keep in mind that the extra calories (sugar, and saturated fat) in your favorite coffee house brew loaded with whipped cream and flavored syrup might offset any health benefits found in a cup of basic black coffee.

Coffee Drawbacks

?While drinking a few cups of coffee every day is good for one’s health, too much can cause problems with sleep, hydration and existing health conditions, which can increase fall risk. Why? One reason for this has to do with the metabolic clearance of caffeine. Older people (above age 65) take 33% longer to metabolize caffeine than younger adults; thus, staying in the nervous system longer. So, drinking multiple cups of coffee in a 24-hour period can quickly cause a buildup of caffeine in the system, leading?to what’s known as the “coffee jitters” (anxiety, headaches, restlessness, heart palpitations, etc.). Also, the chances are good that a late afternoon or early evening cup of coffee will still be processing in the body at 11 pm, keeping the older person from sleeping. What are some other side effects of too much caffeine?

Dehydration?and increased blood pressure?are two untoward effects of caffeine. Dehydration is a leading cause of emergency room and hospital visits among older people, especially during the hot summer months of summer. Drinking coffee instead of water throughout the day contributes to dehydration. While water is always the best choice for quenching thirst, coffee can count towards daily fluid goals. Although, caffeine is a diuretic (in other words it causes increased passing of urine) which causes older people to become dehydrated more quickly, leading to dizziness and increasing their likelihood of falling.

Caffeine may cause a short, but dramatic increase in blood pressure, even if a person doesn’t have high blood pressure. It's unclear what causes this spike in blood pressure. The blood pressure response to caffeine differs from person to person. For people with hypertension, they should ask their doctor about limiting or stopping coffee consumption.

?Coffee can irritate the stomach linings of older people with stomach ulcers and gastritis (caffeine helps produce stomach acid and stimulates gastric acid production). There is, however, no association between coffee consumption and ulcer formation in the stomach or intestine — even among those who drink three or more cups per day.

Lastly, coffee can potentially interfere with the potency of certain medications such as antidepressants, thyroid medication, etc. by reducing absorption into the body. It’s always a good idea to check with the local pharmacy about medications and coffee interactions.

Coffee Recommendations

?Managing coffee (and caffeine) consumption is necessary to prevent unnecessary negative side effects. The healthy quota for daily caffeine is 400 milligrams (roughly four cups of brewed coffee). However, this total doesn’t include caffeine derived from other sources, such as soda, energy drinks, chocolate, decaffeinated coffee (decaf?still contains caffeine but it has reduced levels compared with regular coffee), green tea, coffee-containing foods, (coffee ice cream, bagels, nutritional supplements, etc.). Eating these foods adds to the caffeine count. Checking labels helps to identify foods that contain caffeine.

?How much coffee (caffeine) is too much? Experiencing headaches, dizziness, fast/irregular pulse or heartbeat, anxiety or insomnia may be an indication of too much caffeine. Older persons exceeding the healthy total of caffeine or experiencing unpleasant side effects may want to think about cutting back, switch to decaf or both. According to research, decaffeinated coffee offers similar health benefits as caffeinated coffee.

?In addition to reducing the caffeine intake, changes to when caffeine gets consumed can be made. For instance, by introducing a ”no-caffeine rule” a couple of hours before bedtime, insomnia can improve.

As caffeine is an addictive drug, stopping one’s coffee habit may cause withdrawal symptoms (headaches, fatigue, irritability, lack of concentration, etc.). Therefore, stopping a “coffee fix” should occur gradually.

?Last Words

While coffee for many older people is a safe and healthy drink, the coffee table that they place their cup of coffee on may not be so safe. Every year there are hundreds of falls by older people associated with coffee tables. Common circumstances consist of:

When standing and bending forward, with arm outstretched, to place a cup of coffee onto a low-lying coffee table, a person’s center of gravity shifts to maintain their balance. Most people have the ability to manage this gravity shift and keep upright. However, with old age, reflexes and the ability to adjust to a shifting gravity begins to decrease. As a result, the older person can easily lose their balance and be unable to recover before slamming down hard onto the coffee table, possibly injuring themselves.

With old age, peripheral vision often narrows. A coffee table is typically very low in height and for many older people may not be seen until it is too late, causing the person to bump into the table and lose their balance.

Judging where our bodies are with respect to the environment and objects within it, diminishes with age. An older person with a deficit in spatial awareness has difficulties determining the location of objects in the environment and trouble navigating safely around objects when walking. Therefore, a person may think they have walked past the coffee table, when in fact, they are walking into it.

Finally, for older people, especially those with chronic conditions affecting their mobility, all furniture should have at least 3 feet of clearance from other furnishings and objects. A coffee table is often placed 2 feet or closer to couches or other seating. This space is too narrow for a walker or other types of walking aids to move past. Often those with a walker, for example, will leave their device at the edge of the coffee table, and then attempt to walk to the couch, often very unsteadily. Walking without the walker or other aid for this distance can put an older person at fall risk.

Article, in part, excerpted from: Tideiksaar R. Beating Gravity: Avoiding Falls in Older People. Conversations with a Gerontologist. Independently Published, June 2023. Book link @ Amazon.com?https://a.co/d/dTOCsBh

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