Chapter 11
Falls in the Elderly and Preventive Measures

Gregory F. Marchetti, PhD, PT
Assistant Professor in the Department of Physical Therapy
Duquesne University
Pittsburgh, PA

Susan L. Whitney, PhD, PT, NCS, ATC
Assistant Professor in the Departments of Physical Therapy and Otolaryngology
University of Pittsburgh and the Centers for Rehab Services
Eye and Ear Institute
Pittsburgh, PA

Falling is a very common problem in older adults and can cause catastrophic results. A fall is defined when a person is unable to stay upright and ends up laying on the ground or lower surface. While it’s not uncommon to fall, the consequences can be devastating for seniors. The purpose of this chapter is to provide you with a better understanding of how frequently people fall, who is at risk, what happens to people who fall, and what can be done to prevent it. This will be presented by asking questions we felt you would want answered.

How frequently do falls occur?

Each year in the United States and all other parts of the western world, about three in ten adults over the age of 65 experience a fall. While many older persons will take precautions to prevent further falls, about one to two in ten adults will fall more than once a year. Among those who fall, one out of ten will have a severe injury due to falling. The older a person gets, the greater the chance that he or she will fall. The chance of falling increases to 50 percent by the time a person reaches age 80. The chance of falling gets higher for men above age 65.

What are the consequences of falls to society?

In all countries in the western world, the number of persons older than age 65 is expected to increase. This means that every year, more and more people will experience a fall. There can be grave consequences to the person as result of a fall. An increase in the number of people who will fall also will significantly impact our society and our healthcare system.

Falls are the leading cause of injury-related death in the U.S. Sixty percent of the people who die as a result of falls are older than 65 years. Falls are a source of 87 percent of the fractures sustained by older adults. The injuries that occur due to falls can result in expensive hospital and nursing home care. It is estimated that over three billion dollars is spent annually caring for people who have been injured from a fall. The U.S. government has recognized the burden that falls place on our society and healthcare system. This financial burden is expected to increase as the number of older adults increases. The U.S. government has determined that preventing fall-related deaths and injuries should be a major public health goal.

What can cause me to fall?

Because so many people fall and are injured each year, much research has been done with the aim at prevention. It is known that falls and injuries are probably not totally accidental. A number of risk factors have been identified that increase your chances for a fall. Recognizing these risk factors help you to take preventative measures that may keep you from falling or becoming injured. These risk factors are summarized in Tables 11-2 and 11-3. . .