BMJ  2007;334:169 (27 January), doi:10.1136/bmj.39101.390150.1F

Letters

Preventing falls

Falls need tailored management, fractures risk management

The first 150 words of the full text of this article appear below.

Cameron and Kurrle strike a note of frustration in their editorial accompanying the paper on preventive strategies to minimise falls.^{1 2} Falls in older people are sensitive to several spheres of influence: the physical status of the individual; the mental state of the individual; the influence of environmental factors; the impact of medication, adverse or beneficial; and acts of violence and abuse.

For an individual a fall is generally a symptom of an underlying problem not an explicit diagnostic sign, and therefore multivariate analysis using falls as the index is unlikely to produce a robust understanding. In an audit of admissions to one district hospital we observed that in medical admissions from care homes falls were quite common but that conditions that predisposed to falls such as infection and poorly managed heart failure were ubiquitous.³

Institutional fall rates are probably an unreliable indicator. In reviewing fall data from care homes, occasionally . . . [Full text of this article]

¹ BUPA Care Service, Leeds LS18 4UP bowmanc@bupa.com

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