Preventing Falls and Fractures

Strategy to prevent falls and fracturesThe Health Service Executive, Department of Health and Children and National Council on Ageing and Older people have jointly prepared a strategy to "Prevent Falls and Fractures in Ireland's Ageing Population".

Falls in Older people can have life changing consequences, and older people are most likely to suffer serious injuries, disability, psychological consequences and death following a fall. The risk of falling increases with age - one in three older people fall every year and two-thirds of them fall again within six months. As our population ages the number of falls and injuries in this age group will increase. Today Ireland has 480,000 people over the age of 65, which will increase to one million in 25 years time. By that time, there could be a doubling in the number of falls and fractures that occur if today's rates do not improve. Falls and fractures in older people can be prevented and the strategy being published today outlines a range of measures that should assist older people to avoid falls, and to protect them from the more serious consequences of a fall or fracture.

An economic assessment of falls and fractures shows that today these injuries in older people cost over €400 million to the economy. If current trends continue it is estimated that costs will escalate to €1billion by 2020.

Scientific information shows the extent of the problem of falling in older people:

  • Every year 10% of all older people need medical treatment following an injury - Falls cause 75% of these injuries
  • In Ireland three-quarters of all fall related deaths occur in older people and death rates have been increasing. Fall related deaths increase with age over 65 years and they are higher in older women
  • 2-3% of all injured older people require hospital admission (over 7,000 each year)
  • Hip fractures are one of the most serious injuries due to a fall (approximately 2,800 hospital admissions each year); 80% are over 75 years of age.

Osteoporosis is the most common metabolic bone disease in Ireland and makes bones fragile due to low bone mass. Osteoporosis increases the risk of 'fragility fractures', that is, fractures that would not normally be caused by the injury. Identifying, managing and reducing levels of osteoporosis in the population is an important element of reducing the occurrence and detrimental impacts of falls and fractures.

  • One in three women and one in five men over the age of 50 years of age may have osteoporosis in Ireland
  • Many of them do not know they have this condition as it generally does not declare itself until the first fracture occurs. This means that up to 300,000 Irish people aged 50 years and over may have osteoporosis. The prevalence is rising as the population ages.

Risk factors for falls and fractures are well known so people can reduce their chance of falling and having an injury. The risks of falling include:

  • muscle weakness, poor balance, poor gait or vision, arthritis and other conditions that affect movement like Parkinson's disease
  • some medication can cause a large or sudden drop in blood pressure or cause weakness leading to an increased risk of falling. People who may be taking multiple medications (polypharmacy) that can interact with each other are at increased risk of falling
  • Trips and slips for example on loose mats or wet floors.

What Older People can do to avoid and prevent Falls and Fractures

  1. Keep active and exercise - Regular physical activity makes you stronger and improves balance and coordination. Start with walking and slowly increase the distance you walk
  2. Ask your GP to review your medicines - As you get older you may need to change the dose of your medicines. Some medicines or combinations of medicines may make you feel faint or light-headed which could lead to a fall
  3. Have your vision checked - Your eyesight changes as you get older and poor vision can increase your chances of falling. Make sure you get your eye-sight checked on a regular basis
  4. Look at your environment - Arrange furniture so that you can easily move around all your rooms. Remove rugs or use non-slip tape or backing so rugs will not slip. Fix loose or uneven steps. Have a light switch fitted at the top and bottom of the stairs. Install hand rails on both sides of the stairs. Fit grab rails next to your toilet, bath and shower and use a non-slip mat in the bath or shower.

    Download the HSE Information Leaflet - Preventing Falls here

Prevention and Intervention
The aim of the Strategy is to improve bone health and to prevent to reduce the burden of falls and fractures. It includes best-practice guidelines for falls and osteoporosis. The complete Strategy, an Executive Summary, and a series of technical reports that fed into the strategy are all available to download or read below.

Last updated on: 08 / 08 / 2008