From the Guidelines
Falls in older adults are primarily caused by a combination of age-related physical changes, medical conditions, medications, and environmental hazards, with the most significant risk factors being history of falls, use of certain medications, and gait and balance impairment. The main causes of falls include age-related physical changes such as decreased muscle strength, balance problems, and slower reflexes 1. Medical conditions like Parkinson's disease, arthritis, dementia, and vision problems significantly increase fall risk 1. Medications, particularly sedatives, antidepressants, and blood pressure medications, can cause dizziness or affect balance 1. Environmental hazards in the home such as loose rugs, poor lighting, and clutter are common contributors 1.
Some key factors that contribute to falls include:
- Age-related physical changes: decreased muscle strength, balance problems, and slower reflexes 1
- Medical conditions: Parkinson's disease, arthritis, dementia, and vision problems 1
- Medications: sedatives, antidepressants, and blood pressure medications 1
- Environmental hazards: loose rugs, poor lighting, and clutter 1
- History of falls: a significant risk factor for future falls 1
- Gait and balance impairment: a significant risk factor for falls 1
Understanding these causes helps identify personal risk factors that can be addressed through medication reviews, home modifications, strength training, and proper footwear to prevent future falls 1. Regular physical activity, including exercise and leisure activities, has been shown to be an effective strategy in preventing falls in older adults, with a 23% reduction in the rate of falls compared to controls 1.
From the FDA Drug Label
The risk is increased in those taking concomitant sedatives (including alcohol), and in the elderly. There have been reports of falls and fractures in benzodiazepine users. The causes of falls include:
- Taking concomitant sedatives (including alcohol)
- Being elderly
- Use of benzodiazepines 2
From the Research
Causes of Falls
The causes of falls in older adults are multifaceted and can be attributed to various factors, including:
- History of falls, which is considered the biggest risk factor for falling 3
- Frailty, sedative and anticholinergic drugs, polypharmacy, and medical conditions such as osteoarthritis, visual impairment, and dementia 3, 4
- Age-associated changes in strength and balance, comorbidities, and certain types of footwear 4
- Environmental and situational factors, such as home hazards and poor lighting 4, 5
- Gait and balance disorders, orthostatic hypotension, sensory impairment, and medications 6
- Fear of falling, which can increase the risk of falls 5, 7
- Cognitive impairment, such as dementia, which can affect an individual's ability to navigate their environment safely 5
Risk Factors
Several risk factors have been identified as contributing to the likelihood of falls in older adults, including:
- Prior falls, which can increase the risk of future falls 3, 5
- Balance disorders, which can affect an individual's ability to maintain their balance and prevent falls 6, 5
- Fear of falling, which can lead to decreased mobility and increased risk of falls 5, 7
- Dementia, which can affect an individual's ability to navigate their environment safely 5
- Polypharmacy, which can increase the risk of falls due to the potential for adverse drug interactions and side effects 3, 5
- Sensory and environmental factors, such as poor vision and hearing, which can increase the risk of falls 4, 7