Falls after strokes

They are common and need a multi-intervention approach

Thirty years ago Lord Brain remarked that hemiplegic patients rarely fell because they had to concentrate so hard to walk at all.1 Yet the paper in this issue by Forster and Young, which looks at falls in patients who had had strokes and were living at home, shows that, far from being rare, falls are more than twice as likely in this group than in the rest of the elderly community (p 83).2 So why has our view of this group of patients changed? Probably because, as a result of demographic change and improved rehabilitation and community services, elderly patients living at home now considerably outnumber the younger and fitter patients seen by neurologists in the past.

The important point about the patients in Forster and Young's study is that they were elderly and therefore at an increased risk of falls even without the stroke. About 30% of people over 65 living in the community fall each year,3 4 …