The prevention of falls in later life. A report of the Kellogg International Work Group on the Prevention of Falls by the Elderly

Abstract

Although falls among the elderly carry high costs to individuals and society, the prevention of falls in later life has not received adequate attention from health care professionals. The prevalence of falls appears to involve roughly one-third of persons aged 65 and over, and the risk of falling and suffering serious injury increases substantially up to the eighth decade of life. The proportion of falls which result in fracture is low, but the absolute number of older people who suffer fractures is high and places heavy demands on health care systems. Even falls which result in no physical injury often have serious social and psychological consequences for the elderly, including loss of confidence and restrictions in mobility, and high proportions of older people report fears of falling. There is a need to provide accurate information about the causes and prevention of falls in later life. Falls are not part of the normal aging process. Rather, they are due to underlying physical illnesses, medications, and environmental hazards, often in interaction. This report provides an overview of the elderly population at risk of falling and suffering serious injury, some of the reasons older people fall, and the methods to prevent falls which have been developed in both community and institutional settings. In addition, it suggests some of the practical steps which can be taken by health and social care professionals and by older people and their families in order to prevent falls. Empirical knowledge about the causes of falls by the elderly and the most effective methods of prevention remains limited. Major barriers to research have been the lack of a clear definition of a fall and the fact that falls are not included in medical diagnostic indices. It is recommended that falls be recorded as a disease entity in Index Medicus and in the International Classification of Diseases Xth Revision. To facilitate future comparisons of research findings on falls, a definition of a fall is proposed. The report underscores that the causes of falls are very different for persons of varying ages, health status, and levels of mobility. While the many risk factors for falls are not yet known, poor health status, especially chronic illness, impaired mobility and postural instability, and a history of prior falls have been associated with the risk of falling. Balance, the ability to prevent falls upon displacement, can be impaired by disease or age-related changes in a number of anatomical structures, by medications which reduce their efficient functioning, and by environmental hazards.(ABSTRACT TRUNCATED AT 400 WORDS)