Falls are a major public health concern across the world. With an estimated 424,000 fatalities occurring each year, falls are the second leading cause of unintentional injury and death after road traffic accidents, according to the United Nations health agency.

In the United States, more than one third of older adults, age 65 and above, fall each year, and these fall rates increase with advancing age. Falls are the leading cause of injury-related deaths, the most common cause of non-fatal injuries, and the most common reason for hospital admission due to trauma in older adults. Every hour, there is one death and 183 emergency department visits for falls-related injuries among older adults. More than 95 percent of hip fractures are caused by falls. This risk level may be in part due to physical, sensory and cognitive changes associated with aging, in combination with home and public environments that are not yet adapted for the normal changes that occur with an aging population.

How do you know if you or a loved one is at an increased risk for a fall? It is typically a cumulative effect of several factors which increase fall risk in any one individual. The leading factors are:

• Muscle weakness

• History of past falls

• Gait deficit (difficulty walking or altered walking pattern),

• Balance deficit

• Use of an assistive device to walk (cane, walker, etc.)

• Visual deficits

• Neurological deficits (Such as decreased sensation in legs as sometimes occurs with low back pain or diabetes)

• Arthritis

• Difficulty with activities of daily living (Self-care or small household tasks)

• Depression

• Memory impairment

• Age greater than 80 years

• Multiple or specific medications (Risk increases with daily intake of more than four medications, or if taking psychotropic or medications for arrhythmia, Digoxin or diuretics)

• Cardiovascular deficits (Such as heart rate and rhythm changes, abnormal blood pressure, dizziness when changing positions)

What can you do to prevent falls? The following are some key guidelines recently published by the American Physical Therapy Association:

• Wear your glasses. See your eye care specialist once a year.

• Be careful of pets or young children scurrying under your feet. Remove clutter (including throw rugs) that you might trip over.

• Wear shoes with non-skid soles.

• Get out of bed and stand-up slowly to avoid dizziness.

• Carry a portable phone to avoid running to answer the phone.

• Pace yourself. Fatigue can affect your balance.

• Have your health care provider review your medications.

• See a physical therapist if you feel weak or unsteady.

• Begin a regular exercise program.

• Carry small loads. Heavy loads can throw off balance.

In Part II, we will address specifics of how to start an exercise program with Fall Prevention as the chief goal.