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The Value of Assessing Falls in an Elderly Population

Annals of Internal Medicine

Author: Rubenstein, L. Z., Robbins, A. S., Josephson, K. R., Schulman, B. L., Osterweil, D.
Type: Journal Article
Year: 1990


Objective: To measure the effects of a specialized postfall assessment intended to detect causes and underlying risk factors for falls, and to recommend preventive and therapeutic interventions.Design: Randomized, controlled trial.Setting: A long-term residential care facility for elderly persons.Subjects: Within 7 days of a fall, 160 ambulatory subjects (mean age, 87 years) were randomly assigned to receive either a comprehensive postfall assessment (intervention group, n = 79) or usual care (control group, n = 81).Intervention: The postfall assessment included a detailed physical examination and environmental assessment by a nurse practitioner; laboratory tests; electrocardiogram; and 24-hour Holter monitoring. Probable cause or causes for the fall, identified risk factors, and therapeutic recommendations were given to the patient's primary physician.Measurements and Main Results: Through use of the assessment, many remediable problems (for example, weakness, environmental hazards, orthostatic hypotension, drug side effects, gait dysfunction) were detected. At the end of the 2-year follow-up period, the intervention group had 26% fewer hospitalizations (P < 0.05) and a 52% reduction in hospital days (P < 0.01) compared with controls. Patients in the intervention group had 9% fewer falls and 17% fewer deaths than controls by 2 years, but these trends were not statistically significant.Conclusions: Our study suggests that falls are a marker of underlying disorders easily identifiable by a careful postfall assessment, which in turn can reduce disability and costs.

Further Details

Publish Dates: August 15, 1990
Full Title: Annals of Internal Medicine
Pages: 308-316
Volume: 113
Issue: 4
Accession Number: September, 2011
Notes: Retain Print, not freely available online
Electronic Resource Number: 10.1059/0003-4819-113-4-308
Keywords: falls, aged
Reads: 131