Approach to Falls

Background of falls

Type Clinical features 
Epidemiology 
  • Incidence 
    • Ranges from 30-50% each year of community dwellers > age 65 
    • Up to 50% of people yearly in long-term facilities 
  • Associated complications 
    • Decreased functional status 
    • Higher use of healthcare services 
    • Higher chance of placement in nursing home 
    • Hip fracture or other injuries 
Risk factors for falls 
  • Alcohol use 
  • Cardiac arrhythmias 
  • Cognitive impairment 
  • Decreased vision 
  • Difficulty maintaining appropriate posture 
  • Environmental factors (eg, poor lighting at home, railings) 
  • Female sex 
  • Improper footwear 
  • Medications (eg, neuroleptics, SSRI, antihypertensives) 
  • Musculoskeletal disease (eg, arthritis, muscle atrophy) 
  • Neurologic disease (eg, Parkinson, history of stroke) 
  • Postural hypotension 
  • Previous history of falls 
  • Vitamin D deficiency 
(Next Lesson) Risk assessment for falls
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