Why old people fall (and how to stop them)

Falls in older people are a common, dangerous and frequently incapacitating problem. They are often perceived as being untreatable—but this is an overly negative perspective. In any event, in the next few decades we will increasingly be confronted with elderly fallers as life expectancy continues to rise. This applies particularly to general practitioners, emergency department staff, geriatricians and neurologists. In this review, we will underscore the clinical significance of falls in the elderly and then outline a practical approach for their management. Core elements of this approach include: Falls in the elderly are a major health problem, first and foremost for the affected individuals whose quality of life is markedly reduced, and also for the public health system because of the immense costs associated with falls and the resultant injuries. The risk of falls increases with age: about one third of those over 65 years of age fall at least once a year, and about half of them even more often.1 Apart from age, prominent risk factors include previous falls, female gender, concomitant neurological disease, living in a nursing home, fear of recurrent falling, and regular alcohol intake.2,3 About one third of those over 65 years of age fall at least once a year Falling is serious, for several reasons: