Often, falls go unrecognized by health care practitioners because a specific evaluation for them is not included in the routine history and physical examination and because many persons who fall do not have an obvious injury. Many patients are reluctant to seek assistance because the injury was minimal, because they attribute falling to the aging process, or because they fear being subsequently restricted in their activities or being institutionalized. Epidemiology Falls in the elderly are a major public health problem with substantial medical and economic consequences. Annually, about one third of elderly persons living in the community fall. The rate of falls for elderly hospitalized patients is between the rate for elderly persons living in the community and the rate for elderly nursing home residents.
Most falls occur indoors.
No specific time of day or time of year is associated with falling. Among the elderly, most falls occur during usual activities such as walking. Indoor falls occur most often in the bathroom, bedroom, and kitchen. The first and last steps are the most dangerous. Common sites of outdoor falls are curbs and steps.