Article Text
Statistics from Altmetric.com
Falls in older people are a common, dangerous and frequently incapacitating problem. They are often perceived as being untreatable—but this is an overly negative perspective. In any event, in the next few decades we will increasingly be confronted with elderly fallers as life expectancy continues to rise. This applies particularly to general practitioners, emergency department staff, geriatricians and neurologists. In this review, we will underscore the clinical significance of falls in the elderly and then outline a practical approach for their management. Core elements of this approach include:
-
ascertaining whether or not the patient actually fell
-
reliably classifying the nature of the falls
-
identifying the causes and associated risk factors for falls
-
tailoring an individualised treatment to the identified contributing factors, in order to reduce falls and fall-related injuries, or even to prevent them altogether.
WHY ARE FALLS IMPORTANT?
Falls in the elderly are a major health problem, first and foremost for the affected individuals whose quality of life is markedly reduced, and also for the public health system because of the immense costs associated with falls and the resultant injuries. The risk of falls increases with age: about one third of those over 65 years of age fall at least once a year, and about half of them even more often.1 Apart from age, prominent risk factors include previous falls, female gender, concomitant neurological disease, living in a nursing home, fear of recurrent falling, and regular alcohol intake.2,3
About one third of those over 65 years of age fall at least once a year
Falling is serious, for several reasons:
-
Falls may cause severe injury, and in up to 25% of elderly fallers this requires medical attention.4 Hip fractures are common and widely feared, and secondary complications due to immobility are frequent.
-
Secondary immobility after a fall is …
Linked Articles
- From the editor's desk
Read the full text or download the PDF:
Other content recommended for you
- A prospective study on the variation in falling and fall risk among community-dwelling older citizens in 12 European countries
- Drop attacks: a practical guide
- The different clinical presentations of vasovagal syncope
- Autonomic dysfunction in parkinsonian disorders: assessment and pathophysiology
- Postural hypotension
- Freezing of gait in Parkinson's disease: a perceptual cause for a motor impairment?
- Long-term cardiac monitoring in older adults with unexplained falls and syncope
- Trauma and syncope: looking beyond the injury
- Risk factors for heat illness among British soldiers in the hot Collective Training Environment
- Achilles tendinopathy – pathophysiology: state of the art