About Physiatry

Fall Prevention in the Elderly

Condition: When children or adults fall, they generally do not sustain serious injuries. When the elderly fall, they are more likely to be injured and less likely to fully recover. The elderly also are more prone to falling. However, falls are not an inevitable part of aging and many of them can be prevented.

Background: Nearly 40% of adults over 65 who live in a community setting fall. In nursing homes, this percentage is three times higher. About 10-25% of these people need medical attention.

Risk Factors: Risks can be extrinsic or intrinsic. Examples of extrinsic risks include medications that cause dizziness, poor footwear and a slippery floor.  Examples of intrinsic risks include being over 80, leg weakness, gait/balance issues and decreased vision. As risk factors increase, the likelihood of falls increase.

History and Symptoms: All older persons should be asked yearly if they have fallen. Health providers will look for the presence of risk factors and assess if there are signs of medication side effects.  

Physical Exam: Since falls can be caused by multiple factors, health care providers will conduct a variety of examinations, such as checking a patient’s vital signs, vision, thinking, strength, balance and movement in the joints.

Diagnostic Process: Since falls can be caused by a wide variety of factors, there is no single test that can assess fall risk.  However, blood tests to screen for common health issues that might increase fall risk may be performed.

Rehab Management: Every person faces unique risks. Therefore, assessing and removing or reducing risks are important. Risk prevention may include exercising for strength and balance; eliminating certain medications; and correcting vision impairments.

Other Resources for Patients and Families: The National Council on Aging offers a number of resources such as the Falls Free® National Action Plan. The Centers for Disease Control and Prevention (CDC) also offers tips on how to prevent falls in the elderly.


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