Falls in the elderly.

TLDR

Falls are the leading cause of injury‑related emergency visits and the primary source of accidental deaths in adults over 65, with mortality rising sharply with age and accounting for 70 % of deaths in those 75 +, and they are linked to poor health, hip fractures, and high prevalence among community and nursing home residents. Outpatient assessment of a fall victim involves a focused medication history, a targeted physical exam, and basic postural and functional tests, with treatment aimed at correcting the underlying cause to restore baseline function.

Abstract

Falls are the leading cause of injury-related visits to emergency departments in the United States and the primary etiology of accidental deaths in persons over the age of 65 years. The mortality rate for falls increases dramatically with age in both sexes and in all racial and ethnic groups, with falls accounting for 70 percent of accidental deaths in persons 75 years of age and older. Falls can be markers of poor health and declining function, and they are often associated with significant morbidity. More than 90 percent of hip fractures occur as a result of falls, with most of these fractures occurring in persons over 70 years of age. One third of community-dwelling elderly persons and 60 percent of nursing home residents fall each year. Risk factors for falls in the elderly include increasing age, medication use, cognitive impairment and sensory deficits. Outpatient evaluation of a patient who has fallen includes a focused history with an emphasis on medications, a directed physical examination and simple tests of postural control and overall physical function. Treatment is directed at the underlying cause of the fall and can return the patient to baseline function.