In the DUNLOP study, conditions associated with age such as arthritis, diabetes, heart disease, urinary incontinence, and visual impairment were suggested as predictors of the increased risk of falling among patients..
Balance calls upon contributions from vision, peripheral sensation, vestibular sense, muscle strength, neuromuscular control and reaction time.
With increased age, there is a progressive loss of functioning of these systems and an increased likelihood of falls..
The factors most consistently associated with falls are living alone, depression, fear of falls, and poor subjective health rating.
These findings are discussed in light of stressful events and health..
Common barriers in the home environment include poor flooring conditions, poorly designed tubs, badly arranged furniture, inadequate lighting, and obstructed walkways, all of which potentially increase fall risks [18]..
Environmental factors include home hazards, such as clutter, lack of stair railings, loose rugs or other tripping hazards, lack of grab bars in the bathroom, and poor lighting, especially on stairs..
Environmental factors refer to the conditions and surroundings we live in.
Certain things in our homes, offices, and anywhere we go, including uneven surfaces, poor lighting, clutter, and slippery floors, can contribute to falls by making it difficult to maintain balance or causing slips and trips..
Risk factors for falls in order of evidence strength include a history of falls, impairment in balance, reduced muscle strength, visual problems, polypharmacy (defined as taking over four medications) or psychoactive drugs, gait difficulty, depression, orthostasis or dizziness, functional limits, age over 80 years, .
The most common places to fall are the stairs, bathroom, living room and garden.
Each year, one in four people over 64 years old will fall on the stairs, 13 percent of older adults are injured in the bathroom, 31 percent will take a tumble in the living room, and 23 percent will slip in the garden..
Initiating events involve extrinsic factors such as environmental hazards; intrinsic factors such as unstable joints, muscle weakness, and unreliable postural reflexes; and physical activities in progress at the time of the fall..
Individual characteristics associated with falls have been well-investigated in the literature; however, these traditional risk factors are limited in their ability to predict an individual's acute risk of falling given that many persons with predisposing risk factors do not routinely fall each time they ambulate.
Fall risk escalates as the number of risk factors increases.
The 1-year risk of falling doubles for every added risk factor.
It starts at 8% with no risk factors and increases by up to 78% with four risk factors.
Predisposing risk factors include:
studies of the distribution and determinants of risk factors for falls in populations, especially neuromuscular, sensory, gait, and balance impairments; and monitoring of new drugs and postmarketing surveillance in elderly patients for side effects that cause postural instability and falls. 3.
