Prevention of falls in older patients.

TLDR

Falls are a common geriatric syndrome, affecting 30–40 % of adults over 65 each year, and are linked to higher morbidity, mortality, and nursing‑home placement, with risk factors including muscle weakness, medication use, and impairments in gait, balance, cognition, vision, and activities of daily living. The study identifies multifactorial interventions—targeting identified risk factors, combining muscle‑strengthening and balance training, and withdrawing psychotropic medication—as the most effective strategies for preventing falls. Physicians should assess falls by inquiring about recent incidents, evaluating the circumstances, conducting a comprehensive history and physical examination for risk factors, and performing home‑hazard assessments with professional modification.

Abstract

Falls are one of the most common geriatric syndromes threatening the independence of older persons. Between 30 and 40 percent of community-dwelling adults older than 65 years fall each year, and the rates are higher for nursing home residents. Falls are associated with increased morbidity, mortality, and nursing home placement. Most falls have multiple causes. Risk factors for falls include muscle weakness, a history of falls, use of four or more prescription medications, use of an assistive device, arthritis, depression, age older than 80 years, and impairments in gait, balance, cognition, vision, and activities of daily living. Physicians caring for older patients should ask about any falls that have occurred in the past year. Assessment should include evaluating the circumstances of the fall and a complete history and physical examination, looking for potential risk factors. The most effective fall prevention strategies are multifactorial interventions targeting identified risk factors, exercises for muscle strengthening combined with balance training, and withdrawal of psychotropic medication. Home hazard assessment and modification by a health professional also is helpful.