Approach to falls among the elderly in the community

One in three community-dwelling elderly aged ≥ 65 years and one in two aged > 80 years will have at least one fall within a year. Many elderly people are ‘silent fallers’ who do not report the fall nor seek medical assistance unless they are injured. In Singapore, falls account for 40% of injury-related deaths. Unaddressed risk factors for falls lead to recurrent falls and poor quality of life. Elderly people who have experienced falls and near falls can have a fear of falling, post-fall anxiety syndrome, depression and reduction in activities, with a negative impact on their well-being. Primary care doctors can screen and optimise modifiable risk factors such as poor vision, balance, poor gait, motor weakness, joint disorders, psychotropic drugs, sedatives, anti-hypertension medications, choice of footwear and environment factors. Timely referrals for cataract operations, balance and strengthening exercises, and osteoporosis treatment can reduce the risk of falls and injurious outcomes.