Why the elderly fall in residential care facilities, and suggested remedies

Potential problems with this study

Postprandial hypotension has been reported to be an important precipitating factor for falls in older people³⁷ but was not assessed for in this study. It cannot be excluded that other possible precipitating factors for falls also can have been overlooked or under diagnosed such as syncope, especially in frail cognitively impaired residents.

Final thoughts

The cause of a fall in an older person is multifactorial including combinations of predisposing and precipitating factors often both related to the individual and the environment. An effective clinical strategy for risk assessment and management therefore must address both predisposing and precipitating factors.³⁸

By analogy with accident research in general we think that our focus and analysis of the fall in itself is one fruitful way to approach more effective prevention of this health problem in the older population. It also gives the opportunity to an individualized secondary prevention.

Acknowledgments

The authors acknowledge Staffan Eriksson, Mai Matson, Ellinor Nordin, Erik Rosendahl, Olov Sandberg, and Monica Östensson for their contribution to the data collection. Preliminary results were presented as a poster at the 17th congress of the International Association of Gerontology, Vancouver, Canada, July 2001. This study was financially supported by grants from the County Council of Västerbotten, the Federation of County Councils in Sweden, the Umeå University Foundation of Medical Research, the Gun and Bertil Stohnes Foundation, the Swedish Foundation for Healthcare Sciences and Allergy Research and Erik and Anne-Marie Detlof’s Foundation, Umeå University.

Corresponding author
Kristina Kallin, Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, SE-901 87 Umeå, Sweden. E-mail: kristina.kallin@germed.umu.se.