Introduction

One in three people aged 65 years and over have a fall at least once each year, increasing to one in two of those aged 80 years and over. About five per cent of falls in older people who live in the community result in a fracture or hospitalisation and almost two-thirds of these admissions are in the over 80s. 

Many falls are associated with the use of sedative drugs (e.g. benzodiazepines) and with drugs that can cause postural hypotension (e.g. anti-hypertensives) or may be associated with polypharmacy. However the cause is usually multifactorial. 

Spot the signs

Symptoms and signs that may indicate a risk of falls include:

• Urinary symptoms such as frequency, urgency, not getting to the toilet quickly enough, or having to get up at night to pass urine. Having to rush to the toilet can make a trip or fall more likely
• Dizzy spells or feeling faint.

Arthritis, diabetes, stroke, syncope and Parkinson’s disease can affect mobility and balance so can contribute to the risk of falls. Depression and cognitive impairment are also associated with falls. Something that is frequently overlooked in older people is the role of alcohol in falls. The possibility of problem drinking may need to be tactfully explored.

Useful questions when you suspect frailty and increased risk of falls are:

• Have you fallen in the past year?
• Do you feel unsteady when standing or walking?
• Do you worry about falling?

Older people can help to protect themselves against the likelihood of falling by taking as many of the simple measures suggested in the table below as they can. Explaining why each of these is beneficial is an important role for pharmacy teams as part of their healthy living work.

Source: Age UK