Falls are an ominous yet very real part of life for many over 65, yet often falls can be prevented once the causes are determined. Over 400 risk factors leading to falls have been identified including lack of physical activity resulting in loss of muscle tone, decreased bone mass, poor balance, & reduced flexibility; impaired vision, medications, disease including Parkinson’s, dementia, stroke & arthritis, surgery, and environmental hazards.

The risk of falls and associated complications rises steadily with age and can be a marker of increasing frailty. Frailty is widely accepted to include a combination of factors such as weight loss, fatigue, reduced grip strength, diminished physical activity or slowed gait associated with increased risk of falls, hospitalisation, loss of mobility and independence, increasing disability and death.(2)

The Australian Bureau of Statistics has found that the number of elderly people who die each year from falls has quadrupled over the past decade. 1530 people over the age of 75 died from falls in 2011, compared to 365 in 2002. Falls are also the leading cause of injury-related hospitalisation in persons aged 65 years+ in Australia. In 2011–12, 96,385 people aged 65 and over were hospitalised for a fall-related injury. The increasing rate of fall-related hospital admissions reflects Australia’s ageing population. The number of fall-related hospitalisations for older people has increased 2.3% per year between 1999–00 and 2010–11.

Physiotherapists have become increasingly aware of and concerned about the risk of falls and the hazardous long term effects on the older generation. Physios have seen the devastating effects falls can have on an individual and their loved ones. More often than not they result in serious injury, loss of confidence, and reduced mobility. All of these can subsequently lead to loss of independence and quality of life. For anyone dealing with falls or the risk of falling it can be frustrating and lead to feelings of helplessness and lack of self-esteem.

Physiotherapists can play a crucial role in the prevention of falls in older people. There is evidence that appropriately prescribed interventions can prevent falls. The strongest single predictor of future falls is a history of previous falls. This is probably because an individual’s reason for falling the first time is likely to recur. Assessment of physical functioning is the next strongest predictor.