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What causes a fall?

Falls in older patients are a major and preventable cause of morbidity and the requirement for higher levels of care, as well as mortality. Of the face of it, it seems simple to be able to avoid a fall; just be attentive, careful, 'watch where you are going' but falls are complex and are due to multiple factors based upon not only the physical state a person is in at the time but their environment.

Our senses are vital to avoiding a fall, from an awareness of how are bodies are located in a space, or proprioception, to vision, and balance via the vestibular system of the inner ear, which coordinates with our eye movements (vestibulo-ocular reflex). Our strength and ability to walk normally are important, as are medications such as sedatives. Dementia increases the risk of falls and a patient may be dizzy from diseases affecting the heart or vascular system.

Then there are many environmental considerations like stairs, uneven surfaces, lighting, distractions and the degree of familiarity. If a fall is seen by others, that information can be vital in preventing future falls for that individual, and it is often helpful to write what happened down and discuss this with your doctor. With so many causes, and therefore ways to reduce risk, the good news is that we all can act to prevent falls in the community.

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