[Iatrogenic falls].

Abstract

One third of community-dwelling people, aged 65 years and over, experience a fall each year, and for institutionalized persons the fall frequency is 1.6 times a year. A fracture results in 5% of falls, one in five of which is a hip fracture. In view of this epidemic among the elderly it is obvious that preventive measures are needed. From the patient's history and the clinical assessment a risk of falls can be defined and this should influence decisions regarding drug treatment. Anamnestic data from relatives or neighbours can be important clues to the circumstances of a fall. Supine and standing blood pressure readings (orthostatic drop?) and testing of mobility provide relevant clinical information. To reduce the fall risk in elderly people, drug therapy should not induce daytime fatigue, sedation or drowsiness. Confusion and orthostatic blood pressure drop should be avoided. Long-term drug therapy should be modified or interrupted during acute illness. Electrolyte imbalance should be prevented.