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Falls in older persons: Risk factors and patient evaluation

Douglas P Kiel, MD, MPH
Section Editor
Kenneth E Schmader, MD
Deputy Editor
Daniel J Sullivan, MD, MPH


Falls in older persons occur commonly and are major factors threatening the independence of older individuals. As is the case for many geriatric syndromes, falls usually occur when impairments in multiple domains compromise the compensatory ability of the individual [1].

Falls often go without clinical attention for a variety of reasons: the patient never mentions the event to a healthcare provider; there is no injury at the time of the fall; the provider fails to ask the patient about a history of falls; or either provider or patient erroneously believes that falls are an inevitable part of the aging process. Often, treatment of injuries resulting from a fall does not include investigation of the cause of the fall.

Significant morbidity and mortality may result from falls in older individuals, and falls are the leading cause of injury, both fatal and nonfatal, among older adults in the United States [2]. The importance of preventing falls is emphasized by a study that found that 80 percent of older women preferred death to a "bad" hip fracture that would result in nursing home admission [3].

A number of the physical conditions and environmental situations that predispose to falls are modifiable. Clinicians caring for older patients need to routinely inquire about falls, assess for fall risk, and address modifiable underlying risk factors.

This topic focuses on risk factors and patient evaluation for falls. Measures to prevent falls in older persons are discussed separately. (See "Falls: Prevention in community-dwelling older persons".)

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Literature review current through: Nov 2017. | This topic last updated: Nov 30, 2016.
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