Editorial: A Fall Is a Major Event in the Life of an Older Person

ALLING is a common occurrence. Many of us trip and fall as we go about our daily lives. However, in an older person, a fall can have disastrous consequences. Falls are a major cause of death in older persons (1). Falls are the key event in the pathogenesis of hip fracture (2). Hip frac-tures are associated with a marked decline in functional sta-tus in the year following their occurrence (3,4). Persons who fall often develop fear of falling (5), which leads to isolation and depression (6–8). Fear of falling is strongly associated with impaired instrumental activities of daily living (8). Falling is not only an important marker of frailty (9–11), but frequent falls can play a role in accelerating the downward spiral in a frail older person (12). In Califor-nia, the mean cost of hospitalization following a fall was $17,086 (13). Fallers are often more functional than nonfallers when compared within similar levels of performance. Thus, in the New Mexico Aging Process Study, it was the highly active older individuals who had the most falls (14). In a nursing home study, among wheelchair-bound persons, it was those who had a higher functional level who were more likely to fall (15). Pavol and colleagues (16) demonstrated that, in healthy elderly persons, walking rapidly was the most im-portant reason that an older person fell following an induced trip. Other factors associated with falling after a trip were moving the body’s center of gravity forward and weakness in back and knee extensor muscles. In this issue of the