Will My Patient Fall?

Every year, falls are reported for an estimated one-third of community-dwelling adults over the age of 65. This article reviews the existing literature to identify risk factors that are most predictive of falls. MEDLINE (1966-2004) and CINAHL (1982-2004) were searched for prospective cohort studies of risk factors for falls. The authors provide an in-depth assessment strategy for six common risk factors for falls, including orthostatic hypotension, visual impairment, impairment of gait or balance, medication use, limitations in basic or instrumental activities of daily living and cognitive impairment.

Key Findings:

  • Eighteen studies met inclusion criteria.
  • Based on these studies, the estimated pretest probability of falling at least once in a 12-month period was 27 percent.
  • Patients who have fallen in the past year are more likely to fall again.
  • Clinically detected abnormalities of gait or balance were the only other consistent predictive risk factors for future falls.