According to the National Service Framework for Older People (DH, 2001):
- Falls are a major cause of disability and the leading cause of mortality due to injury in older people aged over 75 in the UK.
- Falls are the leading cause of injury-related hospitalisation in older people and can result in admission to long term care.
- Up to 14,000 people a year die in the UK as a result of an osteoporotic hip fracture.
- One in three women and one in twelve men over 50 are affected by osteoporosis and almost half of all women experience an osteoporotic fracture by the time they reach the age of 70.
- Hip fractures cost the NHS in England around £1.7 billion (estimated at 45% acute care, 50% social care and long term hospitalization, 5% drugs and follow up).
- Problems indirectly associated with falls include:
- psychological problems
- loss of mobility and possible social isolation
- increased dependency and disabilities
- hypothermia
- pressure-related injury
- infections
- Falls are often a common symptom of an underlying health problem.
Risk Factors
- A number of risk factors were identified that may lead to falls:Intrinsic risk factors include:
- balance, gait or mobility problems including those due to degenerative joint
- disease and motor disorders such as stroke and Parkinson's disease
- taking four or more medications, in particular centrally sedating or blood
- pressure lowering medications
- visual impairment
- impaired cognition or depression
- postural hypotension.
Risk factors in the home environment include:
- poor lighting, particularly on stairs
- steep stairs
- loose carpets or rugs
- slippery floors
- badly fitting footwear or clothing
- lack of safety equipment such as grab rails
- inaccessible lights or windows.
- Age (with those over 90 at particular risk) (Fleming, 2008) and lone status (Kharicha et al, 2007) are also highlighted as risk factors
Interventions proven to reduce falls
- Multifactorial assessment and intervention provided by a multidisciplinary team including medical and therapy staff reduces the rate of falls by 30%. Assessments and interventions should include: medication review, orthostatic blood pressure management, gait, balance and strengthening exercises, environmental hazards, vision, cardiovascular risk assessment and patient education.
- Targeted balance and strength exercises in selected community populations reduces falls by 30%.