title: Falls and Fractures: A systematic approach to screening and prevention.
abstract: Falls are one of the major causes of mortality and morbidity in older adults. Every year, an estimated 30-40% of patients over the age of 65 will fall at least once. Falls lead to moderate to severe injuries, fear of falling, loss of independence and death in a third of those patients. Falls account for 87 % of all fractures in the elderly. These fractures are almost always due to low impact injuries in osteoporotic bones. Several organizations have recommended screening older patients to identify those with a high risk of falling and, or fractures. The present review provides a brief summary and update of the relevant literature, summarizing screening tools and interventions to prevent falls and fractures. The major risk factors identified are impaired balance and gait, polypharmacy, and history of previous falls. Other risk factors include advancing age, female gender, visual impairments, cognitive decline especially attention and executive dysfunction, and environmental factors. Recommendations for the clinician to screen and prevent falls in older patients are also summarized.
authors.affiliation: Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, United States. Electronic address: anne.ambrose@mssm.edu.
authors.forename: Anne Felicia
authors.initials: AF
authors.lastname: Ambrose
authors.affiliation: Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, United States.
authors.forename: Lisanne
authors.initials: L
authors.lastname: Cruz
authors.affiliation: Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, United States.
authors.forename: Geet
authors.initials: G
authors.lastname: Paul
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003072:Cognition Disorders; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis* / Q000517:prevention & control*; D005684:Gait; D006801:Humans; D008297:Male; D019338:Polypharmacy; D012307:Risk Factors; D012737:Sex Factors
keywords: Eldely; Fall risk; Falls; Fracture risk