Falls and Falls Prevention in Older Adults: Difference between revisions

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'''<big>Definition</big>'''
'''<big>Definition</big>'''


Revision as of 12:30, 22 November 2023

This article or area is currently under construction and may only be partially complete. Please come back soon to see the finished work! (22/11/2023)

Definition

According to the World health Organisation (WHO), a fall is defined as an event that results in a person coming to rest inadvertently on the ground or floor or other lower level.[1]

Falls are a major health concern and the leading cause of non-intentional injury in older adults (65+). In Australia, falls are leading cause of injury hospitalisation and death, representing 43% of injury hospitalisations and 42% of injury deaths, it's estimated that 10% of falls in older adults will cause a major injury, such as a hip fracture or subdural haematoma. [2]

The financial impact of falls are also significative, for people aged 65 years or older, the average health system cost per fall injury in the Republic of Finland and Australia are US$ 3611 and US$ 1049 respectively. [1]

Causes

Although falls are common within this population, they can't be considered normal. [3] Falls can be caused by intrinsic and extrinsic factors.[4] Intrinsic factors are those related to the ageing process:

  • changes in mobility, balance, and reflexes[5]
  • sarcopenia, functional decline, and reduced muscle strength [6] [5];
  • cognition issues[5]
  • vision and hearing loss [7];
  • urinary incontinence [8];
  • medical conditions, inclusive of untreated pain, vestibular issues, cardiorespiratory issues[9] [5]
  • fear of falling and previous falls[10];
  • gender (older females are more prone to falls than older males)[5] [11];
  • social isolation [5] [12];
  • medications [5];
  • Vit D deficiency [13] [5]

Extrinsic factors are environmental and include a cluttered environment, low lighting, unsafe footwear, uneven surfaces, steps, slippery surfaces, and home hazards such as rugs and mats.

Most factors, both extrinsic and intrinsic, are modifiable and preventable with evidence-based medical and allied health intervention [14]. Best practice on management of falls iand injury prevention include a comprehensive risk and functional assessment of the individual and the implementation of standard and individualised falls prevention strategies.[15]

Risk Assessment

Interventions

References

  1. ↑ 1.0 1.1 https://www.who.int/news-room/fact-sheets/detail/falls
  2. ↑ https://www.aihw.gov.au/reports/injury/falls
  3. ↑ https://www.cdc.gov/injury/features/older-adult-falls/index.html
  4. ↑ Nugraha S, Sabarinah S, Susilowati IH, Rahardjo TB. Intrinsic and extrinsic risk factor for fall among community dwelling Indonesian elderly. Open Access Macedonian Journal of Medical Sciences. 2022 Mar 9;10(B):619-24.
  5. ↑ 5.0 5.1 5.2 5.3 5.4 5.5 5.6 5.7 Appeadu MK, Bordoni B. Falls and fall prevention in the elderly.
  6. ↑ Yeung SS, Reijnierse EM, Pham VK, Trappenburg MC, Lim WK, Meskers CG, Maier AB. Sarcopenia and its association with falls and fractures in older adults: a systematic review and meta‐analysis. Journal of cachexia, sarcopenia and muscle. 2019 Jun;10(3):485-500. BibTeXEndNoteRefManRefWorks
  7. ↑ Gopinath B, McMahon CM, Burlutsky G, Mitchell P. Hearing and vision impairment and the 5-year incidence of falls in older adults. Age and ageing. 2016 May 1;45(3):409-14.
  8. ↑ Moon S, Chung HS, Kim YJ, Kim SJ, Kwon O, Lee YG, Yu JM, Cho ST. The impact of urinary incontinence on falls: A systematic review and meta-analysis. PLoS One. 2021 May 19;16(5):e0251711.
  9. ↑ Lee K, Davis MA, Marcotte JE, Pressler SJ, Liang J, Gallagher NA, Titler MG. Falls in community-dwelling older adults with heart failure: A retrospective cohort study. Heart & Lung. 2020 May 1;49(3):238-50.
  10. ↑ Asai T, Oshima K, Fukumoto Y, Yonezawa Y, Matsuo A, Misu S. The association between fear of falling and occurrence of falls: a one-year cohort study. BMC geriatrics. 2022 Dec;22(1):1-7.
  11. ↑ Johansson J, Nordström A, Nordström P. Greater fall risk in elderly women than in men is associated with increased gait variability during multitasking. Journal of the American Medical Directors Association. 2016 Jun 1;17(6):535-40.
  12. ↑ Zeytinoglu M, Wroblewski KE, Vokes TJ, Huisingh-Scheetz M, Hawkley LC, Huang ES. Association of loneliness with falls: A study of older US adults using the national social life, health, and aging project. Gerontology and geriatric medicine. 2021 Jan;7:2333721421989217.
  13. ↑ Murad MH, Elamin KB, Abu Elnour NO, Elamin MB, Alkatib AA, Fatourechi MM, Almandoz JP, Mullan RJ, Lane MA, Liu H, Erwin PJ. The effect of vitamin D on falls: a systematic review and meta-analysis. The Journal of Clinical Endocrinology & Metabolism. 2011 Oct 1;96(10):2997-3006.
  14. ↑ Bergen G, Stevens MR, Kakara R, Burns ER. Understanding modifiable and unmodifiable older adult fall risk factors to create effective prevention strategies. American journal of lifestyle medicine. 2021 Nov;15(6):580-9.
  15. ↑ https://www.safetyandquality.gov.au/sites/default/files/migrated/30454-RACF-Guidebook1.pdf
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