A neurologist’s perspective of approach to falls in the elderly

Abstract

Abstract Falls constitute an important public health problem that impact the quality of life of an individual. Falls contribute to disability, especially among older adults and elderly individuals. Recurrent fallers are those who fall one or more times per year. The purpose of this article is to provide a detailed systemic qualitative review of the recent definition of falls, their mechanism, risk factors, classification; falls in neurodegenerative disorders; and their approach and management. Sources of literature were drawn from peer-reviewed original and systematic review articles published until January 2024 in the PubMed database using the following key words: falls, elderly, definition, management, etiology, neurodegenerative diseases, epilepsy and fall, dementia and fall, and prevention and diagnostic tests for postural instability and falls. This review summarizes the current understanding of falls and provides a pragmatic and clinically focused approach to their management. Falls are usually multifactorial. Neurodegenerative disorders such as cognitive decline and parkinsonism lead to increased risk of falling. There are several tools to assess the risk of early falls. A multidisciplinary approach is needed in the management of falls. The main goal is encouraging physical activity, home hazard modification, management of postural hypotension, and underlying neurodegenerative diseases.