Times, places, and mechanisms of falls among the elderly

Elderly persons among the population aged 65 years or over in the town of Pori, Finland, falls leading to medical treatment experiencing during one year, are described by age, sex, month, time of day, place, mechanism, estimated cause, previous falls, symptoms before falling, and activity when falling. Results indicate that the falls can be divided into two main categories: falls due to an extrinsic mechanism such as slipping or stumbling, and falls due to an intrinsic or unknown mechanism. Extrinsic mechanisms are more common in the younger age group (65-74 years), in whom falls are dependent on the time of day and amount of activity, and frequently happen outdoors while walking. Thus, slipping is a common extrinsic mechanism. Intrinsic or unknown mechanisms are more common in the older age group (75 years and above), in which estimated causes, such as orthostatic hypotension, fever, dementia, or joint disorders, can in many cases be detected. These cases are not dependent on time of day or month. Falls due to intrinsic or unknown mechanisms are related to rising from a lying or sitting position and lifting the head or turning the body before the fall. Before falling, some kinds of symptoms are more commonly experienced by persons falling due to an intrinsic or unknown mechanism than by those falling due to an extrinsic mechanism.