A WHO global report on falls among older persons

Falls are a major cause of morbidity and mortality in the elderly. A fall results from an interaction of intrinsic and extrinsic factors as well as situational factors and commonly heralds the presence of an underlying medical problem. The incidence of falls and fall related injury increases with advancing age. Older populations of developing countries, including Africa, are expanding and the number of older persons at risk of falls is increasing. Research on falls and related injuries in Africa’s older population is sparse. Few earlier studies reported falls, but recent research on injuries in general has shown that falls are an increasing cause of injury, especially fractures, in the elderly.

Falls, especially recurrent falls, in the elderly are avoidable. A lack of awareness of the syndrome, risk factors and consequences of falls for older persons call for intervention, as they impact not only an individual and her/his family but also society through associated direct and indirect costs. Studies in developed countries show that falls prevention programs are especially effective when targeted at individuals at increased risk of falls: persons age 75 and over and persons with a prior history of falls. Multifaceted fall prevention programs which address interacting risk factors for falls have been shown to be successful in reducing falls and fall related injuries in both community dwelling and institutionalised individuals when offered by trained professionals, but they are labour intensive and costly.

Apart from South Africa, no other African countries provide guidelines for the management and prevention of falls in the elderly. However, despite the availability of the guidelines and a booklet, there is no evidence of their employment in the South African target population. Implementation of falls prevention programs in African countries will be challenging in terms of costs, other priorities, and a lack of awareness of the complexity of falls. Thus, the programs may need to be taken forward in tandem with health promotion programs and research.