page_title: Falls in older adults
section_title: Extrinsic factors
hierarchical_section_title: Falls in older adults / Causes / Extrinsic factors
caption_attribution_description: Geländer in einem Treppenhaus des Bundesministeriums der Finanzen (Detlev-Rohwedder-Haus; früher Reichsluftfahrtministerium bzw. Haus der Ministerien der DDR), Wilhelmstraße 97/Leipziger Straße, Berlin.
context_page_description: Falls in older adults are a significant cause of morbidity and mortality and are a major class of preventable injuries. The cause of falling in old age is often multifactorial and may require a multidisciplinary approach both to treat any injuries sustained and to prevent future falls. Falls include dropping from a standing position or from exposed positions such as those on ladders or stepladders. The severity of injury is generally related to the height of the fall. The state of the ground surface onto which the victim falls is also important, harder surfaces causing more severe injury. Falls can be prevented by ensuring that carpets are tacked down, that objects like electric cords are not in one's path, that hearing and vision are optimized, dizziness is minimized, alcohol intake is moderated and that shoes have low heels or rubber soles.
  A review of clinical trial evidence by the European Food Safety Authority led to a recommendation that people over age 60 years should supplement the diet with vitamin D to reduce the risk of falling and bone fractures. Falls are an important aspect of geriatric medicine.
context_section_description: Poor lighting due to low luminance of existing lights or lamps, so preventing hazard identification and avoidance. Eyesight deteriorates with age, and extra lighting will be needed where seniors move frequently. The power of the bulbs used should be higher than normally accepted, with incandescent bulbs preferred [or LEDs?] especially as they react much more quickly than other types of bulb when switched on. This is vital when entering a room where an obstacle can trip the user for example, especially if not seen in time to prevent the accident.
  Stairs with inadequate handrails, or too steep, encouraging trips and falls. The steps should be spaced widely with low risers, and surfaces should be slip-resistant. Softer surfaces can help limit impact injuries by cushioning loads.
  Doorways with adequate headroom so that the user's head does not hit the lintel. Doorways of low headroom (less than about 2 metres) are common in old houses and cottages for example.
  Rugs/floor surfaces with low friction, causing poor traction and individual instability. All surfaces should have a high friction coefficient with shoe soles.
  Clothing/footwear poorly fitted, shoes of low friction against floor. Rubber soles with ribs normally have a high friction coefficient, so are preferred for most purposes. Clothing should fit the user well, without trailing parts (hems falling below the heel and loose shoe strings) which could snag with obstacles
  Lack of equipment/aids such as walking sticks or walking frames, such as Zimmer frames so as to improve user stability. Grab bars and hanging straps should be supplied plentifully, especially in critical areas where users may be vulnerable.
caption: A staircase with metal handrails
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