Falls

Question 1

What is the prevalence of falls?

Answer 1

Affects around 1/3 elderly in the community

Question 2

What does normal gait involve?

Answer 2

• Neuro system: basal ganglia and cortical basal ganglia loop
• MSK system
• Effective processing of senses e.g sight, sound

Question 3

What are the risk factors of falls?

Answer 3

• Lower limb weakness
• Vision problems
• Balance/gait disturbances
• Polypharmacy
• Incontinence
• Fear of falling
• Postural hypotension
• Arthritis in limbs

Question 4

How should falls be assessed?

Answer 4

• A-E assessment and rule out causes/risk factors
• Basics obs, BP, Glucose, Urine dip, ECG
• FBC, U+E, LFTs
• X-ray of limbs/CT head/Echo if indicated

Question 5

What are the complications of falls?

Answer 5

• Major lacerations
• Traumatic brain injury
• Hip fractures
• Psychological: loss of self-confidence, pain, distress, reduced QOL

Question 6

What are the NICE recommendations for falls?

Answer 6

• Identify all those who have had a fall in last 12 months
• Identify risk factors
• Complete ‘Turn 180’/’Timed up and Go test’
• Offer specialist advice for those over 65 with >2 falls in last 12 months/fail T180/TG test

Question 7

How are falls managed?

Answer 7

• Medication review
• Strength and balance training
• Home hazard assessment
• Vision assessment
• Minimise risk factors