For example, an elderly person is more likely to be seriously injured when falling from an upright position, because more energy is dissipated, or when falling laterally, because impact on the hip is direct. Complications Falls may result in injury, including fractures. If elderly persons remain on the floor for a time after a fall, dehydration, pressure sores, rhabdomyolysis, hypothermia, and pneumonia may result. Falls that do not result in serious injury may still have serious consequences. Elderly persons may fear falling again, which can lead to reduced mobility because of a loss of confidence.
Decreased activity can increase joint stiffness and weakness, further compromising mobility.
Diagnosis Because the elderly often do not report falls, they should be asked about them as a routine part of screening. When falls are reported, acute injuries should be evaluated first. Next, the history and physical examination should focus on intrinsic, situational, and extrinsic factors. The history should also include questions about present and past medical problems and drug use. Witnesses to the fall should be questioned.