Aetiology

Roughly 50% of falls in the elderly follow a trip or an accident, with a mere 5% caused by dizziness. 5% are accompanied by loss of consciousness, 10% are a result of the legs giving way for no reason. The remaining 30% are unexplained.

The reasons for increasing rates of falls, and morbidity associated with falls in the elderly are broadly based on:

• poorer motor responses, with some abnormal gaits, such as that of Parkinson's disease and Alzheimer's disease being more common in the aged
  
  
• poorer protective mechanisms - where the elderly fail to put out their arms to save themselves, leading to reduced upper limb morbidity but increased damage to other structures
  
  
• loss of fitness, as a result of disuse, often as a result of society's expectations

Possible risk factors for falling include:

• history of falls
• gait deficit, balance deficit
• mobility impairment
• visual impairment
• cognitive impairment
• urinary incontinence
• home hazard - poor lighting, loose carpets
• number of medication
• muscle weakness (1)

Reference:

• (1) National institute of clinical excellence 2004. Clinical practice guideline for the assessment and prevention of falls in older people