Falls in the elderly: a practical approach

Falls in the elderly constitute a major problem confronting physicians. Their cost to individual patients and to society in terms of incidence, morbidity, and mortality is enormous. This paper attempts to outline some of the common etiological factors related to falls and a practical approach to the diagnosis and management. Causes of falls are clssified as extrinsic and intrinsic factors. The latter include disorders of many organ systems, especially those resulting from neurological and cardiovascular diseases. The role of drugs and alcohol is stressed. Determining the cause of falls requires a thorough history and physical examination. In order to manage successfully an elderly person with multiple falls, a co-ordinated effort by a multi-disciplinary team is often essential.