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Affiliation
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Department of Medicine, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, New Delhi, India. |
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Abstract
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In the face of an ageing population and disintegrating joint family systems in traditional societies, more and more older persons are moving to old-age residential facilities. While science continues to grapple with the traditional clinical syndromes of old age, it is waking up to new medical problems in an institutionalized elderly cohort. Falls in long-term care facilities and resulting injuries present an evolving challenge in older people because they not only lead to morbidity and mortality but also bring about a loss of autonomy and self- imposed restriction of functionality. Falls have a multifactorial causation and any attempt to prevent, protect or rehabilitate needs to address several wide-ranging issues. The study[1] in this issue of the Journal addresses the risk factors associated with falls in institutional settings in Delhi and presents some insights into their causation as the field of falls research opens up possibilities offered by machine learning techniques and artificial intelligence.[2],[3],[4]
It has been established that the world population is steadily ageing, the proportion of older people is growing and that this trend is likely to continue over the coming decades. Advances in technology and rising social aspirations have led to a disintegration of j oint family systems in traditional societies. As a result, a larger number of people are either choosing to spend the latter parts of their lives in community residential facilities, or they are being forced to do so. An increased demand for such facilities has put strain on the existing establishments leading to unregulated newer arrangements. As systems of informal family caregiving are weakening and facilities for formal long-term care are limited, it is likely that increasing numbers of older persons will be living in old-age homes with inadequate facilities. Newer challenges in ageing are likely to emerge for doctors as more individuals start using old-age residential homes. Injuries and health problems secondary to unexpected falls are a neglected area, which is likely to be of greater importance in the near future.
Falls are complex to understand and difficult to manage due to their multifactorial associations occurring in the immediate ecosystem of the victim—within his residential and work environment. Besides being a leading cause of injury and long-term morbidity in the community, falls pose an important public health challenge for policy-makers and administrators. Falls research revolves around variations of the 4 Ps: (i) estimation of prevalence and incidence ; (ii) prediction and detection; (iii) prevention; and (iv) protection and rehabilitation.
Over 4 decades ago, as many as 668 falls were reported for every 1000 person-years and women had a higher fall rate in all age groups.[5] These rates have not changed much over time and different fall rates have been reported across the world owing to variable definitions and study designs. Prospective data from the English longitudinal study on ageing have indicated ...
Language: en |