Falls in older people

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How should I assess people for risk of falling? 

Identify people aged 65 years and over who:

Have had one or more falls in the last 12 months.

  • Ask about how often the person has fallen, the circumstances in which the fall(s) occurred (such as place, time, activity being performed, and preceding symptoms, for example light headedness or loss of consciousness), and the consequences of the fall(s) (such as injuries, fear of falling, difficulty performing daily activities, activity restriction, and/or pain). If possible, obtain an eye-witness account. 
  • This will help to distinguish a simple fall (caused by a chronic impairment of cognition, vision, mobility, or balance) from a collapse (caused by an acute medical problem, for example, arrhythmias, transient ischaemic attack, or vertigo). Falls in older people

Older people are at risk of falling because they:

  • have a cognitive impairment
  • have a visual impairment
  • have a condition that affects mobility or balance, such as arthritis, diabetes, incontinence, stroke, or Parkinson’s disease
  • are taking multiple drugs, psychoactive drugs (such as benzodiazepines), or drugs that can cause postural hypotension (such as anti-hypertensive drugs)
  • have a fear of falling
  • are physically frail — tools such as the Electronic Frailty Index (eFI) may be used to identify people aged 65 years and over who may be living with moderate or severe frailty
  • have other risk factors for falling, such as alcohol misuse, depression, or environmental hazards.

Reference: cks.nice.org.uk/falls-risk-assessment #!scenarioRecommendation:1