Preventing Falls in Elderly Patients
Falls are the number-one cause of injury-related death among older people in Wisconsin. However, falls are not a natural part of aging, and can be prevented. Learn about the key risk factors for falls, guidelines for prevention and assessment, and when and how to intervene.
The Top Cause of Injury-Related Death Among Elders is Preventable
Falls are the number one cause of injury-related death among people over age 65 in Wisconsin—surpassing motor vehicle accidents by over seven fold. Over half of falls that result in death occur in the home. (1)
Falls also threaten an older adult’s independence and quality of life: nearly two-thirds of Wisconsinites over 65 who are hospitalized because of a fall are discharged afterward to nursing homes. (1)
But falls are not a natural part of aging. Falls can be prevented through appropriate screening, prevention, and intervention.
The following resources are designed to help clinicians, service providers, agencies and families address this major public health concern:
Top Risk Factors: Age, Balance Impairment, History of Falls
Falls among the elderly are most often due to a combination of risk factors, the most significant being advanced age, balance or gait impairment, and a history of falling. Other risk factors include:
In general, the risk of falling increases with the number of risk factors.
A Previous Fall Indicates Further Evaluation, Intervention
Primary care physicians should integrate a falls risk assessment into the history and physical examination of all geriatric patients, whether or not those patients are being seen for a problem with falling. You can view the clinical guidelines from the American Geriatrics Society here.
A previous fall is the most important consideration in the history. Several studies have shown that patients who have had previous stumbles or falls are more likely to fall again (2-5). Of Wisconsin elders admitted to a nursing home, 41% have had a fall in the past 30 days (1).
Patients who are at high risk for a fall, or who have experienced a fall already, should always undergo further evaluation and intervention. This may include:
Participation in an evidence-based community falls prevention program (such as Stepping On, Otago, Sure Step) or group Tai Chi also helps reduce the risk of future falls. Patients are more likely to participate in such a program if referred by their physician.
All older patients should be reassessed for fall risk once a year. This is especially important for patients who take anticoagulants and who are at high risk for life-threatening bleeding from a fall.
Finally, many older patients who fall suffer fractured ribs, an injury associated with a high mortality rate. Evidence shows that these patients have better outcomes if they are treated and monitored at a Level I trauma center (6).
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