Inability to get up after falling, subsequent time on floor, and summoning help: prospective cohort study in people over 90BMJ 2008; 337 doi: https://doi.org/10.1136/bmj.a2227 (Published 17 November 2008) Cite this as: BMJ 2008;337:a2227
All rapid responses
The article from Dr. Fleming is very interesting. Falls are a
frequent cause of morbidity and mortality in the elderly. The risk factors
are immobility (as measured by the Barthel index of neurological
function), agitation, the need for frequent toileting, and visual
impairment(1). Although a few falls have a single cause, the majority
result from interactions between long-term or short-term predisposing
factors and short-term precipitating factors in a person's environment
This article confirms that patients with cognitive impairment and living
alone have a greater risk.
Because falls result from various combinations of factors, an effective
and efficient clinical strategy for risk assessment and management must
address many predisposing and precipitating factors. Some studies have been
done for reducing the risk of falls. An exercise program reduces the risk
of falls 39% (2) Integrated actions should be taken for fall preevention
(3) It also recommends that elderly persons at high risk for falling
receive individualized, multifactorial interventions in settings where
adequate resources to deliver such services are available (4)
Oliver D et al. Development and evaluation of evidence based risk
assessment tool (STRATIFY) to predict which elderly inpatients will fall:
Case control and cohort studies. BMJ 1997 Oct 25 315 1049-1053.
Campbell AJ et al. Randomised controlled trial of a general practice
programme of home based exercise to prevent falls in elderly women. BMJ
1997 Oct 25 315 1065-1069.
Robitaille, Y., Gauvin, L. (2008). Fall prevention in older adults:
towards an integrated population-based perspective. Inj. Prev. 14: 147-148
Preventive Services Task Force. Guide to clinical preventive
services: report of the U.S. Preventive Services Task Force. 2nd ed.
Baltimore: Williams & Wilkins, 1996:659-85.
Competing interests: No competing interests