Who is at risk
Having a fall can happen to anyone, however, as people get older, they are more likely to fall over. This is because the prevalence of many falls risk factors increase as people grow older. Risk factors can be divided into intrinsic and extrinsic categories (Table 1). Falls generally occur due to the interplay of multiple risk factors.
Table 1- Examples of intrinsic and extrinsic risk factors for falls
| Intrinsic | Extrinsic |
|---|---|
| Frailty | Environmental hazards |
| Poor strength & balance | Poor fitting footwear |
| Visual impairment | Winter weather |
| Cognitive disturbances | Polypharmacy |
| Low blood pressure | Excess alcohol use |
| MSK conditions e.g. arthritis | |
| Neuro-disabilities |
In addition to identifying risk factors for sustaining a fall, it is also worth considering factors which increase the risk of poor health outcomes following a fall. For example, osteoporosis is associated with a greater risk of sustaining a fracture following a fall. Fragility fractures represent a significant burden associated with falls and can result in prolonged hospitalisation, de-conditioning and even mortality.
Inequalities
The risk of falls can also be indirectly influenced by factors such as gender and deprivation status. In England, women are more likely to be admitted to hospital with a fall compared with men (Figure 1). Similarly, those in the most deprived decile are more likely to be admitted to hospital with a fall compared with those in the least deprived decile (Figure 2).
Figure 1- Trend of emergency hospital admissions due to falls in people aged 65 and over for England, shown for males, females and the England average (persons). Data source: OHID Fingertips.
Figure 2- Trend of emergency hospital admissions due to falls in people aged 65 and over for England, shown for the most and least deprived deciles. Data source: OHID Fingertips.
