Falls: Prevention and Management

  • Sunita PaulEmail author


  • Falls are common in older people—30% of people over 65 years of age and 50% of people over 80 years of age are likely to fall within the next year, the fifth leading cause of death in elderly.

  • Five percent of older fallers will have a major injury such as fractured neck of the femur, subdural hematoma, etc.

  • Following a fall 30–40% of fallers develop fear of falling and curtail their activities.

  • Falls are expensive, and there needs to be a 66% reduction in incidence of falls to maintain current healthcare costs.

  • Falls are preventable, and a systematic approach to identifying risks and addressing them in a concerted manner is key to prevention.


  1. 1.
    Tinetti ME. Where is the vision for fall prevention? J Am Geriatr Soc. 2001;49:676–7.CrossRefPubMedGoogle Scholar
  2. 2.
    Tinetti ME, Speechley M. Prevention of falls among the elderly. N Engl J Med. 1989;320:1055–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Deandrea S, et al. Risk factors for falls in community dwelling older people: a systematic review and meta-analysis. Epidemiology. 2010;21(5):658–68.CrossRefPubMedGoogle Scholar
  4. 4.
    Oliver D, et al. Preventing falls and falls related injuries in hospitals. Clin Geriatr Med. 2010;26(4):645–92.CrossRefPubMedGoogle Scholar
  5. 5.
    Campbell AJ, Spears GF, Borrie MJ, et al. Falls, elderly woman and the cold. Gerentology. 1988;34:205–8.CrossRefGoogle Scholar
  6. 6.
    Campbell AJ, Borrie MJ, Spears GF. Risk factors for falls in a community-based prospective study of people 70 years and older. J Gerontol. 1989;44:M112–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Young SW, Abedzadeh CB, White MW. A fall-prevention program for nursing homes. Nurs Manage. 1989;20:80AA. 80DD, 80FFCrossRefGoogle Scholar
  8. 8.
    Kerse N, Butler M, Robinson E, Todd M. Fall prevention in residential care: a cluster, randomized, controlled trial. J Am Geriatr Soc. 2004;52:524–31.CrossRefPubMedGoogle Scholar
  9. 9.
    Tinetti ME, Baker DI, McAvay G, et al. A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med. 1994;331:821–7.CrossRefPubMedGoogle Scholar
  10. 10.
    Guideline for the prevention of falls in older persons. American Geriatric Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention. J Am Geriatr Soc 2001;49:664–72.Google Scholar
  11. 11.
    Kannus P, Sievanen H, Palvanen M, et al. Prevention of falls and consequent injuries in elderly people. Lancet. 2005;366:1885–93.CrossRefPubMedGoogle Scholar
  12. 12.
    Tinetti ME, Doucette J, Claus E, et al. Risk factors for serious injury during falls by older persons in the community. J Am Geriatr Soc. 1995;43:1214–21.CrossRefPubMedGoogle Scholar
  13. 13.
    Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319:1701–7.CrossRefPubMedGoogle Scholar
  14. 14.
    Leipzig RM, Cumming RG, Tinetti ME. Drugs and falls in older people: a systematic review and meta-analysis: II. Cardiac and analgesic drugs. J Am Geriatr Soc. 1999;47:40–50.CrossRefPubMedGoogle Scholar
  15. 15.
    Lepizig RM, Cumming RG, Tinetti ME. Drugs and falls in older people: a systematic review and meta-analysis: I. Psychotropic drugs. J Am Geriatr Soc. 1999;47:30–9.CrossRefGoogle Scholar
  16. 16.
    Gillespie LD, Gillespie WJ, Robertson MC, et al. Interventions for preventing falls in elderly people. Cochrane Database Syst Rev 2003;CD000340.Google Scholar
  17. 17.
    Bischoff HA, Stahelin HB, Dick W, et al. Effects of vitamin D and calcium supplementation on falls: a randomized control trial. J Bone Miner Res. 2003;18:343–51.CrossRefPubMedGoogle Scholar
  18. 18.
    Gallagher JC. The effects of calcitriol on falls and fractures and physical performance test. J Steroid Biochem Mol Biol. 2004;89-90:497–501.CrossRefPubMedGoogle Scholar
  19. 19.
    Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing. 2006;35(Suppl 2):37–41.Google Scholar
  20. 20.
    Gillespie LD, Robertson MC, Gillespie WJ, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012;9:CD007146.Google Scholar
  21. 21.
    Sherrington C, Whitney JC, Lord SR, et al. Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatr Soc 2008;56:2234-2243Google Scholar
  22. 22.
    El-Khoury F, Cassou B, Charles MA, et al. The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults: systematic review and meta-analysis of randomized controlled trials. BMJ. 2013;f6234:347.Google Scholar
  23. 23.
    Rose DJ, Hernandez D. The role of exercise in fall prevention for older adults. Clin Geriatr Med. 2010;26:607–31.CrossRefPubMedGoogle Scholar
  24. 24.
    Dargent-Molina P, Khoury FE, Cassou B. The “Ossébo” intervention for the prevention of injurious falls in elderly women; background and design. Glob Health Promot. 2013;20:88–93.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Lord SR, Castell S, Corcoran J, et al. The effect of group exercise on physical functioning and falls in frail older people living in retirement villages: a randomized, controlled trial. J Am Geriatr Soc. 2003;51:1685–92.CrossRefPubMedGoogle Scholar
  26. 26.
    El-Khoury F, Cassou B, Latouche A, Aegerter P, Charles M-A, Dargent-Molina P, et al. Effectiveness of two year balance training programme on prevention of fall induced injuries in at risk women aged 75–85 living in community: Ossébo randomised controlled trial. BMJ. 2015;351:h3830.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Campbell AJ, Robertson MC, La Grow SJ, Kerse NM, Sanderson GF, Jacobs RJ, Sharp DM, Hale LA, et al. Randomised controlled trial of prevention of falls in people aged ≥75 with severe visual impairment: the VIP trial. BMJ. 2005;331:817.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Kosse NM, Brands K, Bauer JM, Hortobagyi T, Lamoth CJ. Sensor technologies aiming at fall prevention in institutionalized old adults: a synthesis of current knowledge. Int J Med Inform. 2013;82(9):743–52. doi: 10.1016/j.ijmedinf.2013.06.001. Epub 2013 Jul 8CrossRefPubMedGoogle Scholar

Copyright information

© The Editor(s)  2018

Authors and Affiliations

  1. 1.Middlemore HospitalAuckalndNew Zealand

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