Causes and correlates of recurrent falls in ambulatory frail elderly

To determine causes and clinical correlates of recurrent falls in ambulatory frail elderly people, we evaluated 70 recurrent fallers and 56 nonfallers (mean age = 87 years) from two long-term care facilities. Evaluations included a detailed history, physical examination, performance-oriented mobility assessment, and laboratory studies. Primary causes including stroke, parkinsonism, blindness, drug-related hypotension, and arthritis were established for the most recent fall in 51 (73%) fallers. Eighteen fallers (26%) had multiple conditions that could not be prioritized for their contribution to the fall. Fallers were more often women, were functionally more impaired, and were taking more medications than nonfallers. Specific diseases did not distinguish fallers from nonfallers. Fallers of both sexes took more steps to turn 360 degrees, could not stand up from a chair without pushing off, had a higher prevalence of antidepressant use, and had impaired position sensation. These easily obtained clinical variables characterized nearly three-quarters of ambulatory elderly nursing home residents with a history of recurrent falls.