Falls in older adults

Falls in older adults are a significant cause of morbidity and mortality and are a major class of preventable injuries. Falling is one of the most common accidents that cause a loss of function, independence, and quality of life for older adults, and is usually precipitated by multiple risk factors. The cause of falling in old age is often multifactorial, and a multidisciplinary approach may be needed both to prevent and to treat any injuries sustained. The definition of a "fall" tends to vary depending on who is reporting the fall and to whom. It is generally accepted that falling includes dropping from a high position to a low one, often quickly. But a fall does not necessarily mean falling to the ground: the individual could fall back into a chair or bed, and they may be assisted by another person to help slow down the fall and perhaps avoid injury. The severity of injury is generally related to the height of the fall and the individual's health: for example whether there is osteoporosis. The type of surface onto which the person falls is also important: harder surfaces can cause more severe injury. Sometimes falls can be prevented by ensuring that interior surfaces are dry and free of clutter, carpets are tacked down, paths are well lit, hearing and vision are optimized, dizziness is minimized, alcohol intake is moderated and shoes have low heels or rubber soles. External surfaces are harder to control, but ideally to reduce falls, it can be helpful to walk on surfaces that are not wet or icy, are well lit, are flat; and to have hands and arms free to help regain balance or protect from a fall.

A review of clinical trial evidence by the European Food Safety Authority led to a recommendation that people over the age of 60 years should supplement their diet with vitamin D to reduce the risk of falling and bone fractures. Falls are an important aspect of geriatric medicine. In 2018, the United States Preventive Service Task Force actually recommended against vitamin D supplementation to help prevent falls, citing lack of association or conflicting results between the supplement and reduced falls in older adults. Rather, older adults should be screened for osteoporosis; and if diagnosed the need to slow or stop bone loss is paramount. This can be accomplished through proper nutrition, lifestyle changes, exercises, fall prevention strategies and some medications.