Services vary depending on geography (e.g. availability of day hospital, home assessment by physio etc). Please also refer to locality guidelines for MoE opens a new window services and the above supporting pages.
Falls are increasingly common with age. There can be multiple causes for falls including acute illness, and falls can often co-exist with the onset of delirium. Falls can result in severe injury including fractures and head injuries, with associated consequent morbidity and mortality. Fear of falling can be debilitating for older people, and hard to treat. Realistic prescribing is important in older people; the risks of polypharmacy (including falls) increase with age.
It can be difficult to determine the reason for a fall, and one single reason may never be identified.
There are a number of risk factors; modifiable and non-modifiable. The purpose of a comprehensive geriatric assessment is to identify all risk factors and address as many of the modifiable risk factors as possible. Risk factors for falls include (but are not limited to):
| Age | Postural hypotension |
| Sarcopenia / low body weight | Syncope of any cause |
| Sensory impairments particularly eyesight | Medications (esp. high anticholinergic burden) |
| Dizziness and vertigo (central or peripheral cause) | Number of medications (polypharmacy) |
| Dementia | Incontinence |
| Neurological conditions e.g. Parkinsonism, stroke disease, neuropathy | Alcohol |
| Delirium of any cause | Metabolic disturbances (e.g. hypoglycaemia) |
| Pre-existing MSK injury or pain | Inappropriate walking aids |
| | Environmental factors (stairs, loose rugs etc.) |
