Research shows that approximately 30% of those age 65 or older fall each year. It's the most common way elderly people are injured and can lead to costly medical bills, disability, nursing home admission, or death. A recent literature review undertaken to determine which risk factors might predict falls in the elderly found that having fallen during the prior year and having a gait or balance problem are the most consistent predictors of future falls.

Other risk factors commonly evaluated to predict falls are orthostatic hypotension; impairments of vision, cognition, or performance of basic or instrumental activities of daily living; and medication use. But the researchers found that these factors were significantly less accurate predictors of risk than were a history of falls and balance or gait problems. In a teleconference, the authors suggested asking all older patients, "Have you fallen in the past year?" and "Do you have walking or balance problems?" "If the answer is yes," said the study's lead author, David Ganz, "they have a 50-50 chance of falling" and can be considered to be at high risk; the researchers recommend that clinicians then perform a "multifactorial evaluation for prevention" that includes assessing all of the risk factors commonly used to predict falls, as well as assessing the home environment to reduce hazards.

The researchers found that screening older patients in this way can reduce falls by 30% to 40%. In the teleconference, Ganz also noted that, because they are ill and in an unfamiliar environment, "all older inpatients should be considered at high risk for falls."

Linda Epstein, BSN, RN

Maureen Shawn Kennedy, MA, RN, news director