EPIDEMIOLOGY OF FALLS AND FALL-RELATED IN JURIES IN THE ELDERLY

Approximately one third of elderly persons over the age of 65 who live in the community fall each year. About 5% of falls result in a fractu re, and 5 to 10% of them result in other serious injuries requiring me dical care. Even in the absence of serious physical injury, falls may have severe psychological consequences leading to an accelerated decli ne in functional capacities. Several epidemiological studies have iden tified the main intrinsic risk factors for fall. These include advance d age, female sex, impaired balance, gait abnormalities, reduced muscu lar strength, cognitive deficiencies, impaired visual acuity and use o f sedative-hypnotic medications. The results of recent epidemiological studies comparing falls with serious physical injuries to falls witho ut injuries suggest that, besides bone mass, the speed and effectivene ss of protective reflexes may greatly influence the risk of trauma aft er a fall. Contrary to what may be believed, the frequency of falls an d fall-related trauma is also high in active and healthy subjects. How ever, the cause of falls are clearly different for persons of varying age, health status and level of mobility. Several authors have tried t o define different types of falls according to the predominance of int rinsic or extrinsic factors in fall aetiology. This approach may allow to identify different risk factors or combinations of risk factors ac cording to the type of falls or to the characteristics of fallers.