PubMed · 1478508
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P A Miller. 1992. Suggestions for improving a falls prevention program.. https://doi.org/10.1093/geront%2F32.6.859
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Because of the smaller functional resources, the risk for falls in elderly persons is significantly increased when they take sedative anxiolytics with long half life, antipsychotics, antidepressants and, not so well documented, antihypertensives. Nonpharmacological strategies are, therefore, the treatment of choice for insomnia, depression and agitation in the elderly.
The risk of falling increases with age and with many of the disorders common in late life. Approximately 35 to 40% of community-dwelling people over the age of 65 and up to 50% of institutionalized elderly fall at least once every year. The incidence is highest in women and the very old. Hip fracture, one of the most serious injuries associated with falls, assumes epidemic proportions in old people. In addition to physical injury, falls can have other serious consequences for the older person. Repeated falls are a common reason for the admission of previously independent elderly persons to long-term care institutions. This article examines why older people fall and what factors place persons at risk for falling. The multiple reasons for an inconsistency of the epidemiological data are discussed.
Falls with transitory loss of consciousness (syncopes) are mainly due to cardiovascular incidents and show a significant higher risk of injuries than falls without loss of consciousness. The frequency of syncope is increasing with advancing age. Syncope represents an important disease with epidemiologic consequences in the older age group. The broad etiologic spectrum of syncope and the significance of diagnostic methods are discussed. Five case reports are added as illustration. Medical history, clinical examination and ecg-recordings are the most important diagnostic tools in the evaluation of syncope. An in depth investigation of patients with syncope reduces the rate of recurrence and risk for injury, it increases the quality of life and results in lower medical costs.