At least one-third of community-dwelling people over 65 years ofage fall each

year (Campbell 1990; Tinetti 1988), and the rate offall-related injuries increases
with age (Peel 2002). Falls can have serious consequences, such as fractures and
head injuries (Peel2002). Around 10% of falls result in a fracture (Campbell
1990; Tinet-ti 1988); fall-associated fractures in older people are a
significantsource of morbidity and mortality (Burns 2016). Although most fall-
related injuries, such as bruising, lacerations and sprains, are lessserious, they
can still lead to pain, reduced function and substantial health care costs (Burns
2016).
Falls are associated with reduced quality of life (Stenhagen 2014),and can have
psychological consequences: fear of falling and loss of confidence that can
result in self-restricted activity levels leading to a reduction in physical function
and social interactions (Yardley2002). Paradoxically, this restriction of activities
may increase the risk of further falls by contributing to deterioration in physical
abil-ities. Both injurious and non-injurious falls can have these psycho-logical
and subsequent physical impacts.
Reason fall

Risk Factors for Falls

• A history of falls • Impaired strength, balance, and gait • Visual impairment • Polypharmacy •
Use of psychotropic medications • Postural hypotension • Environmental risks
Home Modification Tips
• Remove throw rugs and mats from living spaces, including bathrooms. Alternatively, affix rugs
and mats to floors, making sure the edges do not create a tripping hazard. • Remove clutter from
living spaces, entryways, and hallways. • Improve lighting throughout the home. • Although
many modifications can be made by the older adult, caregiver, or other family members and
friends, more complicated modifications, such as the installation of a ramp at an entryway, may
require the assistance of a professional. • Involve social workers in securing financial assistance
for durable medical equipment and home modifications. • Arrange furniture to ensure there is
space for the older adult to perform exercises.

to avoid falling
many aspects of physical functioning deteriorate with increasedage and
inactivity. Impairments in muscle strength, balance controland gait are
particularly strong risk factors for falls (Tinetti 1988).For example, those with
poor leg extensor strength were found tobe 43% more likely to fall at home than
their stronger counterparts(Menant 2017). Systematic reviews have found that
those with gaitproblems have twice the odds of falling than those without (De-
andrea 2010), and that measures of balance and mobility such asthe Berg
Balance Scale, Timed Up and Go Test, and Five Times Sit-to-Stand Test can
identify individuals at greater risk of future falls.

effectiveness of two programmeson older adults at risk of falling:

unsupervised homeexercise and supervised group exercise