Fall Prevention

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Facts About Falls

Clinical Approach

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Connecticut
Collaboration for
Fall Prevention

Clinical Approach

Falls and fall injuries are one of the most common health problems among older adults. However, since falling is not a single disease, clinicians may not recognize falling as a treatable health problem. The consequences of untreated falls and risk factors can be just as serious as those of other untreated chronic diseases. The risk of falling increases as the number of risk factors an older person has for falling increases.

Occurrence of falls according to the number of risks.
Tinetti, M.E., Speechley, M. and Ginter, S.F. (1988).

While some factors that increase risk of falling, such as age and previous falls, cannot be changed, there are a number of important ones that can be - problems walking or moving around, taking 4 or more medications, foot problems or unsafe footwear, blood pressure dropping too much on getting up, problems seeing, and tripping hazards at home. Research has shown that treating and correcting these specific health problems reduces the rate of falling by more than 30%. The table below shows how an older person with fall risk factors can benefit from treatment of those factors.

Falls Risk Reduction Table
If she has	The chance she will suffer a serious fall in the next year is	Treating risk factors reduces this risk about 1/3 to
Fallen in past year	50% (5 in 10)	30% (3 in 10)
No falls in past year but even minor problems with walking or movements	30% (3 in 10)	20% (2 in 10)
Any 1 of 6 the risk factors below	20% (2 in 10)	10% (1 in 10)
Any 2 of the 6 risk factors below	30% (3 in 10)	20% (2 in 10)
Any 3 of the 6 risk factors below	60% (6 in 10)	40% (4 in 10)
4 or more of the 6 risk factors	80% (8 in 10)	50% (5 in 10)

The known treatable risk factors include:

any problems with walking or movements [see below]
postural hypotension
use of 4 or more medications or any psychoactive medications
unsafe footwear or foot problems
visual problems
environmental hazards

Observe for problems with one or more of these movements:

steady standing on one leg for at least five seconds
steady getting up from a chair
sits down in a chair without plopping

While walking...
walk path is straight
turns are steady
swing foot always passes the stable foot by at least a foot length (normal step length)
heel of the swing foot always hits the floor first (heel-toe sequencing)