Until the 1940s, falls and fall-related injuries were considered accidents, that is “acts of God,” random or chance events without observable or understandable explanations.1 However, beginning with the early studies by Droller, Sheldon, and Fine, falls have increasingly been recognized as predictable, and potentially preventable, health problems worthy of careful investigation.2–4 As evidenced by their association with other functional problems, such as incontinence, and by a high mortality rate not due to injury, falls by the very frail elderly may simply be markers for deterioration. However, falls by elderly persons other than the very frail appear to result from either single specific causes or, more often, from the accumulated effect of multiple identifiable risk factors.


Nursing Home Postural Hypotension Elderly Person Nursing Home Resident Cervical Spondylosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Hogue CC. Epidemiology of injury in older age. In: Second Conference on the Epidemiology of Aging. 1980; NIH publication No. 80–969. pp. 127–138. 21.Google Scholar
  2. 2.
    Droller H. Falls among elderly people living at home. Geriatrics 1955;May:293–344. 22.Google Scholar
  3. 3.
    Sheldon JH. On the natural history of falls in old age. Br Med J 1960; 2: 1685–1690.PubMedCrossRefGoogle Scholar
  4. 4.
    Fine W. An analysis of 277 falls in hospital. Gerontol Clin 23. 1959; 1: 292–300.Google Scholar
  5. 5.
    Campbell AJ, Reinken J, Allan BC, et al. Falls in old age: 24. A study of frequency, and related clinical factors. Age Ageing 1981; 10: 264–270.PubMedCrossRefGoogle Scholar
  6. 6.
    Prudham D, Evans JG. Factors associated with falls in 25. the elderly: A community study. Age Ageing 1981; 10: 141–146.PubMedCrossRefGoogle Scholar
  7. 7.
    Tinetti ME, Speechley M, Ginter SF. Predisposing and 26. situational risk factors for falls in community elderly (submitted).Google Scholar
  8. 8.
    Rubenstein LZ, Robbins AS, Schulman BL, et al. Falls 27. and instability in the elderly. J Am Geriatr Soc 1988; 36: 266–278. 28.Google Scholar
  9. 9.
    Baker SP, Harvey AH. Fall injuries in the elderly. Clin Geriatr Med 1985: 1: 501–508.PubMedGoogle Scholar
  10. Kennedy TE, Coppard LC,. The prevention of falls in 29. later life. Danish Medical Bulletin. Supplement 4, 1987.Google Scholar
  11. 11.
    Melton LJ, Riggs BL. Risk factors for injury after a fall. Clin Geriatr Med 1985; 525–536.Google Scholar
  12. 12.
    Tinetti ME: Instability and falling in the elderly. Seminars in Neurology (accepted).Google Scholar
  13. 13.
    Wolfson LI, Whipple RH, Amerman PM, et al. Gait and balance in the elderly: Two functional capacities that link sensory and motor ability to falls. Clin Geriatr Med 1985; 1: 649–659.PubMedGoogle Scholar
  14. 14.
    Tobis JS, Reinsch S, Swanson JM, Byrd M, Scharf T. Visual perception dominance of fallers among community-dwelling adults. J Am Geriatr Soc 1985; 33: 330333.Google Scholar
  15. 15.
    Hazel JWP. Vestibular problems of balance. Age Ageing 1979; 8: 258–260.CrossRefGoogle Scholar
  16. Wykce B. Cervical articular contributions to posture and gait: Their relations to senile disequilibrium. Age Ageing 1979; 8: 251–258.CrossRefGoogle Scholar
  17. 17.
    Koller WC, Glatt SL, Fox JH. Senile gait: A distinct clinical entity. Clin Geriatr Med 1985; 1: 661–669.PubMedGoogle Scholar
  18. 18.
    Whipple RH, Wolfson LI, Amerman PM. The relationship of knee and ankle weakness to falls in nursing home residents: An isokinetic study. J Am Geriatr Soc 1987; 35: 13–20.PubMedGoogle Scholar
  19. 19.
    Tinetti ME, Williams TF, Mayewski R. Fall risk index for elderly patients based on number of chronic disabilities. Am J Med 1986; 429–34.Google Scholar
  20. 20.
    Mader SL, Josephson KR, Rubenstein LZ. Low prevalence of postural hypotension among community-dwelling elderly. JAMA 1987; 258: 1511–1514.PubMedCrossRefGoogle Scholar
  21. 21.
    Lipsitz LA. Syncope in the elderly. Ann Int Med 1983; 99: 92–105.PubMedGoogle Scholar
  22. 22.
    Ray WA, Griffin MR, Schaffner W, et al. Psychotropic drug use and the risk of hip fracture. N Engl J Med 1987; 316: 363–369.PubMedCrossRefGoogle Scholar
  23. 23.
    Owens DH. Maintaining posture and avoiding tripping. Clin Geriatr Med 1985; 1: 581–599.Google Scholar
  24. 24.
    Canadian Task Force on the Periodic Health Examination: The periodic health examination. Can Med Assoc J 1979; 121: 1193–1254.Google Scholar
  25. 25.
    Wild D, Nayak USL, Isaacs B. Characteristics of old people who fell at home. J Clin Exper Gerontol 1980; 2: 271–287.Google Scholar
  26. 26.
    Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc 1986; 34: 119–126.PubMedGoogle Scholar
  27. 27.
    Tinetti ME, Ginter SF. Identifying mobility dysfunctions in elderly patients. JAMA 1988; 259: 1190–1193.PubMedCrossRefGoogle Scholar
  28. 28.
    Mathias S, Nayak USL, Isaacs B. The “Get up and Go” test: A simple clinical test of balance in old people. Arch Phys Med Rehabil 1986; 67: 387–389.PubMedGoogle Scholar
  29. 29.
    Tideiksaar R. Preventing falls: Home hazard checklists to help older patients protect themselves. Geriatrics 1986; 41: 26–28.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1990

Authors and Affiliations

  • Mary E. Tinetti

There are no affiliations available

Personalised recommendations