Prevention of falls and fall related injuries in older people in nursing homes and hospitals

Older people in residential care fall about three times as frequently as those living in the community. In part, this reflects higher incidences of risk factors for falls such as mobility limitations and dementia. Also, falls are an independent risk factor for admission to a nursing home. Falls in hospital settings are higher still: results from a Swedish study amounted to 6.2 falls per person year in a psychogeriatric ward, 3.4 falls per person year in a geriatric rehabilitation ward, and 1.1 falls per person year in a nursing home. Falls in nursing care facilities and hospitals often result in serious injuries and are associated with considerable mortality and morbidity. For example, rates of hip fracture as a result of falls in nursing care facilities have been estimated to be 10.5 times higher than in the community. Outcome too is poorer, as older people who fall while in hospital settings have significantly longer lengths of stay and are more likely to be discharged to a nursing home. Falls in these settings are thus a major public health issue and a wide range of interventions for preventing falls, often aimed at moderating risk factors, have been proposed and implemented. This points to the importance of the recent publication in the Cochrane Database of Systematic Reviews of a comprehensive systematic review that examines the effects of interventions for preventing falls in older people living in nursing care facilities and hospitals.