Fall and Fracture Prevention in the Elderly

Prevention of falls among elderly persons is a high priority in many countries. Guidelines explicitly recommend special services for fall prevention in high-risk groups, including the elderly presenting after a fall, recurrent fallers and nursing home residents. Multifaceted interventions are recommended for both community-dwelling older persons and residents of long-term care facilities.1,2 Implementation of these guidelines will have considerable resource implications. Amajor concern is not only the high incidence of falls, but also the high disposition to fall-related injuries resulting in considerable morbidity and functional decline. It has been estimated that 20% of falls require medical attention,3,4 and 10% result in a fracture.5,6 However, only two of the many prevention strategies available appear to reduce the incidence of fall-related injuries, the main outcome of interest. Hip protectors are of proven benefit to reduce the incidence of hip fractures,7-9 while home-based exercise programs administered by qualified professionals are likely to reduce the number of falls resulting in injury.10 In this article, we present a brief overview of the effectiveness of non-pharmacological fall and fracture prevention approaches targeted at community-dwelling elderly and residents of long-term care facilities. Methods