The World Health Organization (WHO) has updated its fact sheet on falls recently.
A fall is defined as an event which results in a person coming to rest inadvertently on the ground or floor or other lower level. Fall-related injuries may be fatal or non-fatal, though most are non-fatal.
Falls are the second leading cause of accidental or unintentional injury deaths worldwide.
Each year an estimated 646 000 individuals die from falls globally of which over 80% are in low- and middle-income countries.
Adults older than 65 years of age suffer the greatest number of fatal falls.
37.3 million falls that are severe enough to require medical attention occur each year.
Such falls are responsible for over 17 million DALYs (disability-adjusted life years) lost. The largest morbidity occurs in people aged 65 years or older, young adults aged 15–29 years and children aged 15 years or younger.
Older people have the highest risk of death or serious injury arising from a fall and the risk increases with age. This risk level may be in part due to physical, sensory, and cognitive changes associated with ageing, in combination with environments that are not adapted for an aging population.
Another high risk group is children. Childhood falls occur largely as a result of their
- evolving developmental stages,
- innate curiosity in their surroundings, and
- increasing levels of independence
that coincide with more challenging behaviours commonly referred to as ‘risk taking’.
While inadequate adult supervision is a commonly cited risk factor, the circumstances are often complex, interacting with
- sole parenthood, and
- particularly hazardous environments.
Across all age groups and regions, both genders are at risk of falls. In some countries, it has been noted that males are more likely to die from a fall, while females suffer more non-fatal falls. Older women and younger children are especially prone to falls and increased injury severity.
Worldwide, males consistently sustain higher death rates and DALYs lost. Possible explanations of the greater burden seen among males may include higher levels of risk-taking behaviours and hazards within occupations.
Other risk factors include:
- occupations at elevated heights or other hazardous working conditions;
- alcohol or substance use;
- socioeconomic factors including poverty, overcrowded housing, sole parenthood, young maternal age;
- underlying medical conditions, such as neurological, cardiac or other disabling conditions;
- side effects of medication, physical inactivity and loss of balance, particularly among older people;
- poor mobility, cognition, and vision, particularly among those living in an institution, such as a nursing home or chronic care facility;
- unsafe environments, particularly for those with poor balance and limited vision.
For older individuals, fall prevention programmes can include a number of components to identify and modify risk, such as:
- screening within living environments for risks for falls;
- clinical interventions to identify risk factors, such as medication review and modification, treatment of low blood pressure, vitamin D and calcium supplementation, treatment of correctable visual impairment;
- home assessment and environmental modification for those with known risk factors or a history of falling;
- prescription of appropriate assistive devices to address physical and sensory impairments;
- muscle strengthening and balance retraining prescribed by a trained health professional;
- community-based group programmes which may incorporate fall prevention education and Tai Chi-type exercises or dynamic balance and strength training;
- use of hip protectors for those at risk of a hip fracture due to a fall.
For children, effective interventions include
- multifaceted community programmes;
- engineering modifications of nursery furniture, playground equipment, and other products; and
- legislation for the use of window guards.
Link to the updated fact sheet:
Link to WHO Global Report on Falls Prevention in Older Age (English) [PDF] (2007):