Among older adults, falls are the leading cause of injury deaths, unintentional injuries, and hospital admissions for trauma. Falls can take a serious toll on older adults’ quality of life and independence. Falls occur due to a loss of balance and an inability to recover balance.
The complex set of conditions and circumstances that lead to this loss of balance are known as fall-related risk factors.
There are four main systems that work together to control balance and prevent falling: visual, vestibular, somatosensory, and musculoskeletal systems.
Balance Sensors
• Brain
• Eyes
• Inner Ear
• Muscles
• Joints
• Sense of Touch
Factors Contributing to a Fall
Falls are caused by a loss of balance or the inability to regain balance. However, the contributors to this are complex.
The factors that contribute to a loss of balance are represented by four categories:
- biological
- behavioural
- social/economic
- environmental factors
Risk is also compounding, with the presence of four or more factors leading to an almost 80 per cent increase in risk of falling (older person).
Biological Factors
Biological risk factors include those pertaining to the human body and are related to the natural aging process, as well as the effects of chronic, acute or palliative health conditions.
Biological risk factors include advanced age, decreased mobility and balance, muscle weakness, visual impairment, acute or chronic illness and disability (i.e. cognitive impairment, stroke, arthritis).
Some conditions cannot be changed, such as gender or age, while others may be prevented or compensated for, such as muscle weakness or poor vision.
Behavioural Factors
Behavioural risk factors for falling include actions, emotions or choices of the individual.
Behavioural risk factors include history of falls, fear of falling, poor nutrition and/or hydration, lack of physical activity, inappropriate footwear and clothing, and taking multiple medications, particularly psychoactive medications like tranquilizers or antidepressants.
Social and economic factors
Research has shown that one’s income, education, housing and social connectedness all bear a strong relationship to one’s health, level of disability, longevity and cognitive function.
Individuals with low income, low education, inadequate housing, a lack of support networks and limited access to appropriate health or social services are all at increased risk of having the chronic health conditions that are highly associated with an increased risk of falling or being injured from a fall.
Environmental factors
Studies have shown that on average, 50 to 60 percent of falls occur within the home.
Environmental factors include home hazards, such as clutter, lack of stair railings, loose rugs or other tripping hazards, lack of grab bars in the bathroom, and poor lighting, especially on stairs.