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Abstract
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This month an Observer headline reported a 177% increase in deaths from falls among men over 85 from 2008 to 2016, although the population of over 85s rose only 19%. It linked the story to serious cuts in social care funding and provision in that period: a fall from 15% to 9% of over 65s receiving council funded care. It’s hard to establish a causal link, but the story highlights the importance of falls to our health and care services.
Around a third of over 65s and half of over 80s fall at least once a year, and half fall again in the same year. Falls are the leading cause of death from injury in over 70s and account for around half of all hospital admissions for injury. Even “minor” soft tissue injuries can be disabling in frailer older people, and falls can lead to loss of confidence and independence.
Falls lead to fractures, including around 80 000 hip fractures a year in the UK and a further 200 000 non-hip fractures.
For several years the Department of Health and national arm’s length bodies have led programmes on prevention, assessment, and treatment of people with falls and fragility fractures, with the momentum around this issue including a coalition of interested professional bodies and charities. The Royal College of Physicians (RCP) leads a long running national audit of falls and fragility fractures, and NICE has guidelines on them. Outcomes and processes for patients with hip fractures have improved.
Falls result from individual patients’ risk factors, the activities they engage in, and their physical environment. As such, fall prevention is ideal territory for structured, multidisciplinary, comprehensive geriatric assessment and tailored interventions for each risk factor. And it’s amenable to well evidenced single interventions—most notably, structured strength and balance training exercise, which can be formally supervised by trained instructors who needn’t be clinicians ...
Language: en |