geriatrics
Falls in Older Adults
Introduction
A fall is defined as an event that occurs when a person inadvertently drops down to the ground or another lower level; sometimes a body part strikes against an object that breaks the fall. Typically, events caused by acute disorders (eg, stroke, seizure) or overwhelming environmental hazards (eg, being struck by a moving object) are not considered falls. In people ≥ 65, falls are the leading cause of injury-related death and the seventh leading cause of all deaths ( References ). In the United States, about 14 million (about 28%) adults age ≥ 65 report falling each year, accounting for a total of about 36 million falls each year according to the Centers for Disease Control and Prevention (CDC [ References ]). Not all falls result in an injury, but about 37% of people who fall report an injury that required medical treatment or that restricted their activity for at least one day, resulting in an estimated 8 million fall injuries each year ( Falls threaten the independence of older adults and cause a cascade of individual and socioeconomic problems. However, clinicians are often unaware of falls in patients who do not present with an injury because a routine history and physical examination typically do not include a specific evaluation for falls. Many older adults are reluctant to report a fall because they attribute falling to the aging process or because they fear being subsequently restricted in their activities or institutionalized. Reporting falls to clinicians is necessary for prevention of future falls. When falls are not reported and preventive measures are not instituted, patients are at risk of falling again, thereby placing a significant burden on the health care system. This burden is expected to increase given the projected growth of the aging population. 