Prevention of falls in patients with osteoporosis

Falls are a significant problem among elderly individuals. Approximately 30% of elderly persons fall each year. The clinical effect of falls also is important. Falls are the leading cause of nonfatal and fatal injuries among elderly individuals. Hip fractures are one of the most disabling consequences of falls; falls contribute to more than 90% of the 250,000 hip fractures each year in the United States.Much has been learned about risk factors for falls among elderly persons. The major risk factors are diseases or impairments that affect balance, gait, or muscle strength. Impaired visual acuity and diminished sensory function also are important causes of falls. Specific medications and the number of medications also have been well documented to correlate with the risk of falling. Prevention of falls is now a clinical reality. Several interventions have been shown to reduce the rate of falling or fallrelated osteoporotic fracture. Exercise, including exercises to improve muscle strength, aerobic capacity, and balance, reduce the rate of falls and improve bone strength. Environmental modifications or extrinsic factors also may prevent specific fall-related fractures, such as the use of hip pads to prevent hip fractures. Healthcare providers should include assessments of fall risk factors and counseling about preventive measures in the routine care of all elderly persons, but particularly among those with osteoporosis.