ABSTRACT
Susceptibility to falling increases considerably with ageing (Lord et al. 2001). One in three older people living in the community are likely to fall one or more times in a year, and falling rates are higher in older people living in residential care. The actual definition of a fall in older people, however, has been open to some debate. A frequently used definition is “unintentionally coming to the ground or some lower level and other than as a consequence of sustaining a violent blow, loss of consciousness, sudden onset of paralysis as in stroke or an epileptic seizure” (Gibson et al. 1987). This definition excludes overwhelming external disturbances that result in an older person being knocked over and major internal disturbances that cause an older person to collapse instead of fall. Depending on the focus of study, however, some researchers have used a broader definition of falls to include those that occur because of dizziness and syncope. Although falls are often referred to as accidents, it has been demonstrated statistically that they are not random events (Grimley-Evans 1990). This implies that causal processes are involved, and many studies have been undertaken with the aims of identifying fall risk factors. In broad terms, these risk factors can be classified as being of a demographic, psychosocial, medical, physical or environmental nature (Lord et al. 2001), and strategies and guidelines for addressing these factors to prevent falls have recently been devised (Feder et al. 2000; American Geriatrics Society et al. 2001; Lord et al. 2001). This chapter reviews the work that addresses the epidemiology of falls in older people, physical and environmental fall risk factors, and uniform and multifaceted strategies for preventing falls in this group.
