Falls in older adults

Falls among older adults are a major cause of illness and death, and they are largely preventable. They are one of the most frequent accidents leading to a loss of function, independence, and quality of life, typically triggered by a combination of factors. Because the reasons for falling in later life are usually multiple and interconnected, preventing falls and treating resulting injuries often requires a team of different specialists.

What counts as a fall can vary depending on who is describing it and to whom, but the general idea is a rapid drop from a higher position to a lower one. A fall does not have to end on the ground—someone might fall back into a chair or bed, and another person might help slow the fall to avoid injury. How severe the injury is usually depends on the height of the fall and the person’s health, such as whether they have osteoporosis. The surface someone lands on also matters; harder surfaces tend to cause worse injuries.

Some falls can be prevented by keeping indoor floors dry and free of clutter, securing carpets, making sure paths are well lit, optimizing hearing and vision, minimizing dizziness, limiting alcohol, and wearing low-heeled or rubber-soled shoes. Outdoor surfaces are harder to manage, but it helps to walk on dry, non-icy, well-lit, flat ground and to keep hands and arms free to help regain balance or break a fall.

A review of clinical trials led the European Food Safety Authority to recommend that people over 60 take vitamin D supplements to lower their risk of falling and bone fractures. However, in 2018, the United States Preventive Services Task Force advised against vitamin D for fall prevention, citing a lack of clear evidence linking the supplement to fewer falls in older adults. Instead, they recommended screening for osteoporosis; if diagnosed, the priority is to slow or stop bone loss through proper nutrition, lifestyle changes, exercise, fall prevention strategies, and some medications.

Other definitions of a fall are broader and do not exclude "major intrinsic events." Falls are a concern in medical facilities, and preventing them is usually a priority in healthcare settings. A 2006 review of research highlighted the need for a standard falls classification because of variation across studies. The Prevention of Falls Network Europe (ProFane) developed a taxonomy to address this, defining a fall as "