Falls are a leading cause of mortality and morbidity in older adults aged over 65, impacting both physical and mental health. Around a third of people aged 65 years and over fall each year, increasing to half of those aged 80 and over.
Approximately 5% of those who fall will suffer from fractures and be admitted to hospital. Falls, and fear of falling, have a significant individual human cost, and in terms of health care services. In Cornwall, hospital admissions due to hip fracture in people aged over 65, and 80 year olds are broadly similar to average rates across England, with a higher rate amongst women in both age groups. However, there is substantial variation across communities.
After a hip fracture, an estimated 50% of people nationally can no longer live independently.
Fear of falling is the most commonly reported anxiety among older people (Skelton & Todd 2004) and falls and fear of falling are associated with increased anxiety and depression, decreased mobility, reduced social contact, higher medication use, and increased dependence on medical and social services and informal carers (Yardley & Smith 2003). Fear of falling can also cause older people to limit their movement, not just in terms of habitual activity but also in their normal body movements. This unwillingness to move can lead to poor compliance with exercise interventions and even avoidance of a particular activity that led to a past fall. Fear of personal injury is often cited as a reason for people not taking part in regular indoor and outdoor physical activity (Skelton 2001). Fear of falling and falls self efficacy can be improved with regular exercise (Skelton & Todd 2004).
