Journal Club August 2015: Falls in the Elderly Population

Article title: Falls in older people: epidemiology, risk factors and strategies for prevention

Author: Laurence Z. Rubenstein

Journal: Age and Ageing, 2006

Discussion:  Falls are a major cause of morbidity and mortality in the elderly. Nearly 40% of older adults fall

at least once a year and 10-20% of these falls result in injury. Half of those hospitalized for a fall injury

died within one year. Falls are the cause of 45.4% of unintentional injury deaths in the elderly (CDC,

2009). However, studies have shown that most falls are associated with identifiable risk factors, many of

which are preventable. It is imperative that physicians can identify these risk factors and take appropriate

measures to reduce the risk of falls. Furthermore, effective methods to prevent falls have been developed

and should be utilized in the clinic setting.

    This review article by Laurence Rubenstein, MD, MPH is a quality summary of the epidemiology

and risk factors associated with falls in the elderly. Data from many major studies related to falls in the

elderly have been compiled, condensed, and contextualized in a clear summary of the most important risk

factors, clinical findings, and preventions. Dr. Rubenstein has identified those risk factors that are

modifiable and outlined the most efficacious means to prevent falls in the elderly. Furthermore, as a

clinician, Dr. Rubenstein has included recommendations on the clinical evaluation of patients who have

suffered a fall, adding to the value of this paper for medical students and residents.

Among the top causes of falls in those >65 years old are accidents, gait/balance disorders,

dizziness, confusion, and visual disorders. Some of these major causes are obvious and are clearly the

inevitable course of aging, however, many causes of falls are secondary to other things such as

medications, autonomic dysfunction, or even just the fear of falling. This study highlights the variety and

complexity of factors that contribute to falls in the elderly and emphasizes both the importance of a

complete medical evaluation in patients who have suffered a fall and the value of preventative measures.

Preventive measures - including environmental modification, exercise, and balance conditioning - have all

proven very effective in reducing falls.

    First it is essential to recognize the significant morbidity/mortality caused by falls in the elderly.

Having an understanding of the severity of this problem underlines the importance of taking measures to

prevent falls in patients over 65 years old.


LEARN MORE by downloading the article and discussion below:

Article - Link to Full Article

Discussion - Age and Aging Journal Club Aug 2015