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post-fall assessment

An Organized Approach to Post-Fall Assessment

An Organized Approach to Post-Fall Assessment

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Identifying Modifiable Risk Factors in Order to Prevent Future Falls

D'Arcy Little, MD, CCFP
Director of Medical Education and Research
York Community Services, Toronto, ON

Introduction and Epidemiology
Falls are a major health problem for the elderly and have been referred to as one of the "Geriatric Giants."1 The annual incidence of falls among the community-dwelling elderly is estimated to be 30% among those between 65 and 80 years of age, and 50% among those over 80 years of age.2 The annual incidence of falls among elderly nursing home residents is estimated to be 50%, with 40% of residents suffering multiple falls each year.2

Falls are a cause of significant morbidity and mortality in the elderly. Accidents are the 6th leading cause of death in persons over 65, and falls are estimated to be responsible for two-thirds of these deaths.2 As a result, falls directly or indirectly cause 12% of deaths within the geriatric population.3 In addition, up to 50% of falls in the elderly give rise to soft-tissue injury, with 5% of these being classified as serious. One percent of falls results in hip fractures, and two-thirds of these patients are unable to return to their pre-fracture functional level. Up to 5% of falls give rise to other varieties of fractures.