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| |  Repeated Falls In The Elderly Could Be Prevented Through In-Hospital Assessment LONDON, ENGLAND -- Jan. 8, 1999 -- In this week's issue of The Lancet, Dr. Jacqueline Close and colleagues from London, England, report that a more thorough assessment of elderly people who attend hospital after a fall can lower the risk of further falls and limit psychological and physical damage. They found that eight percent of people aged 70 years and above seek care in accident and emergency departments each year for fall-related injuries. Of these, 30 to 40 percent are admitted to hospital. The cost of a fall is high -- both to the individual in terms of physical and psychological trauma, loss of independence, or even death and to health and allied services in terms of resources and bed occupancy. However, there is still no agreed approach to the management of elderly people who fall and previous studies have produced conflicting results. The researchers analysed the benefit of a structured interdisciplinary assessment of people who had fallen in terms of further falls. Eligible patients were aged 65 years and above, lived in the community and presented to an accident and emergency department with a fall. The researchers randomly assigned 184 patients to the intervention group and they underwent a detailed medical and occupational-therapy assessment with referral to relevant services if indicated. Another 213 patients were randomly assigned to a control group and received usual care only. All patients were followed up every four months for one year. At 12 months, 77 percent of both groups remained in the study. The total reported number of falls during this period was 183 in the intervention group compared with 510 in the control group. The risk of falling was 61 percent lower in the intervention group compared with the control group and the risk of recurrent falls was 67 percent lower in the intervention group. The researchers suggest that preservation of bone mineral density and the use of hip protectors in high-risk groups could help in any future programme to prevent falls and injury. "We conclude from our findings that there is now a strong case to incorporate falls and injury prevention programmes into routine clinical service," they write. Related Links: The Lancet
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