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Falling is a common problem in older people. Amongst people over the age of 65, around one in three living in the community, and around half of those in care homes, fall each year. Falls increase in frequency with advancing age and increasing frailty.
Falls can have many consequences. Injuries can range from bruising and lacerations to serious head injuries and fractures. They can result in pain, disability, loss of independence, hospitalisation and, in some cases, death. The psychological impact can include fear of further falls and loss of confidence both of which can result in social isolation. The burden to caregivers and family can also be substantial, with falling often cited as a reason for admission to care homes. There are also significant economic implications; in the year 2000 the cost of treating fall-related injuries was estimated to be $19 billion dollars in the US. Clearly falls in older age are a significant public health issue.
Falls used to be considered an inevitable consequence of aging, but this is not the case. This special collection contains four Cochrane reviews which focus on the prevention of falls and fall-related injuries in older people, and provide evidence of effective interventions.
Interventions for preventing falls in older people living in the community
Approximately 30% of people over 65 years of age living in the community fall each year. This update of a Cochrane review first published in 2009 assesses the effects of interventions designed to reduce the incidence of falls in older people living in the community.
Interventions for preventing falls in older people in care facilities and hospitals
Falls in care facilities and hospitals are common events that cause considerable morbidity and mortality for older people. This update of a Cochrane review first published in 2010 assesses the effectiveness of interventions designed to reduce falls by older people in care facilities and hospitals.
Population-based interventions for the prevention of fall-related injuries in older people
Fall-related injuries are a significant cause of morbidity and mortality in older populations. Population-based interventions in the form of multi-strategy, multi-focused programmes are hypothesised to result in a reduction in population-wide injury rates. This review assesses the effectiveness of population-based interventions, defined as coordinated, community-wide, multi-strategy initiatives, for reducing fall-related injuries among older people.
Hip protectors for preventing hip fractures in older people
Hip fracture in older people usually results from a fall on the hip. Hip protectors have been advocated as a means to reduce the risk of hip fracture. This review aims to determine if external hip protectors reduce the incidence of hip fractures in older people following a fall.
Acknowledgements: With thanks to Professor David Stott for drafting the introduction text and selecting the reviews for this collection, comments and edtis, and to Mrs Lesley Gillespie and Dr Helen Handoll for selecting the reviews for this collection, and for comments and edits.
 Stevens JA, Corso PS, Finkelstein EA, Miller TR. The cost of fatal and non-fatal falls among older adults. Injury Prevention 2006;12:290-5.
Image credit: Chris Priest/Science Photo Library, M340/0162
Date published: 28 February 2013
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