Falls in older people
Separating syncope from mechanical falls, the World Falls Guidelines risk stratification, multifactorial assessment, fall-risk-increasing drugs, anticoagulation in fallers, the long lie, post-fall care in hospital and which prevention measures have evidence.
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Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- About 1 in 3 people over 65 fall each year, and half of those over 80. Falls are the leading cause of injury hospitalisation and injury death in older Australians.
- A fall is a symptom, not a diagnosis. Most have several causes: gait and balance, drugs, vision, cognition, orthostatic hypotension, environment.
- Ask every older person about falls. Stratify risk with the World Falls Guidelines (2022) algorithm; Australia's ACSQHC Falls Guidelines (2025) apply the same approach across hospital, residential and community care.
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Sources
- Preventing Falls and Harm from Falls in Older People: Best Practice Guidelines for Australian Hospitals (with companion guidelines for residential aged care and community care; first revision since 2009)AU/NZAustralian Commission on Safety and Quality in Health Care, 2025
- World guidelines for falls prevention and management for older adults: a global initiative (Montero-Odasso M et al. Age Ageing 2022;51:afac205)World Falls Guidelines Task Force (Age and Ageing), 2022
- Falls: assessment and prevention in older people and in people 50 and over at higher risk (NG249)National Institute for Health and Care Excellence, 2025
- Exercise for preventing falls in older people living in the community (Sherrington C et al. Cochrane Database Syst Rev 2019;1:CD012424)Cochrane, 2019
- Multifactorial and multiple component interventions for preventing falls in older people living in the community (Hopewell S et al. Cochrane Database Syst Rev 2018;7:CD012221)Cochrane, 2018
- Carotid sinus syndrome, should we pace? A multicentre, randomised control trial (SAFE PACE 2) (Ryan DJ et al. Heart 2010;96:347-51)Heart, 2010
- Carotid sinus syndrome: a modifiable risk factor for nonaccidental falls in older adults (SAFE PACE) (Kenny RA et al. J Am Coll Cardiol 2001;38:1491-6)Journal of the American College of Cardiology, 2001
- STOPPFall (Screening Tool of Older Persons Prescriptions in older adults with high fall risk): a Delphi study (Seppala LJ et al. Age Ageing 2021;50:1189-99)Age and Ageing, 2021
- Determinants of the decision to anticoagulate elderly patients with atrial fibrillation who are at risk for falls (Man-Son-Hing M et al. Arch Intern Med 1999;159:677-85)Archives of Internal Medicine, 1999
- Fall prevention education to reduce falls in older people in rehabilitation units: a cluster randomised trial (Hill AM et al. Lancet 2015;385:2592-9)Lancet, 2015
- Effects of an intervention to increase bed alarm use to prevent falls in hospitalized patients: a cluster randomized trial (Shorr RI et al. Ann Intern Med 2012;157:692-9)Annals of Internal Medicine, 2012
- Annual high-dose oral vitamin D and falls and fractures in older women: a randomized controlled trial (Sanders KM et al. JAMA 2010;303:1815-22)JAMA, 2010
- Last updated
- 14 November 2026
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