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Falls represent an important and critical event for older persons. Falls due to trips, slips, and stumbles occur during the stance and swing phase of the gait cycle. They are initiated by a combination of intrinsic and extrinsic events. Intrinsic causes include age-related declines in visual, vestibular, proprioceptive, and musculoskeletal function. Extrinsic factors encompass environmental obstacles associated with foot-ground contact.
The purpose of this study was twofold: (1) to determine, in a group of older persons with multiple trip and slip falls, the underlying intrinsic and extrinsic factor responsible, and (2) to investigate whether medical and environmental intervention would reduce falls. Twenty-five older persons were examined. They experienced a total of 102 falls; 75% due to slips, and 25% the result of trips. Intrinsic abnormalities of the gait cycle (Parkinsonism and peripheral neuropathy) and decreased vision due to cataracts, in combination with extrinsic or environmental foot-ground conditions (that is, low-frictional resistant or irregular ground surfaces) were found to be the leading cause of slips and trips.
A one-year follow-up, after medical and environmental interventions, showed that fourteen persons experienced no additional falls, nine continued to fall, but less frequently, and two persons continued to fall as often as before.
aged, falls, slips, trips, stumbles, gait, environment, ground surfaces, foot-ground contact, vision, vestibular, proprioceptive
Director, The Mount Sinai Medical CenterThe Jewish Home and Hospital for Aged, New YorkNew York, NYNY