Falls in Older Adults

Over 25% of community-dwelling older adults over the age of 65 fall at least once per year and falls are the number one cause of accidental death and injury in older adults. The percentage of older adults who report a fall increases with age with 34% of those 85 years and older having fallen in the past year. The causes of falls are multifactorial with both intrinsic factors – such as age-related decline and chronic disease – as well as extrinsic factors – such as environmental hazards – contributing. Mediating factors contributing to falls include risk-taking behaviors and acute illness. The consequences of falls can be severe for older adults as they threaten ongoing independence, lead to morbidity and mortality, result in decreased overall functioning, can lead to early admission to long-term care, and increase ED visits and hospitalizations. Screening for fall risk in the outpatient setting is recommended annually to identify those at risk for falls. Evidence-based interventions for falls prevention include medication review, exercise programs that include muscle strengthening and balance training, vitamin D supplementation, ensuring appropriate footwear, and home safety evaluations. The optimal intervention for older adults for falls prevention includes screening for fall risk, identifying relevant risk factors, and tailoring an intervention to address the patient’s modifiable risk factors in ways that address their goals, values, and preferences.