New research from The Irish Longitudinal Study on Ageing (TILDA) at Trinity College Dublin shows that falls represent a major and growing problem for the health system in Ireland. Despite tens of thousands requiring medical care each year following a fall, there is a significant lack in appropriate services.
The ‘DEFINED Study: Determining the Burden of Falls Amongst Community-Dwelling Older People in Ireland to Inform Falls Care Delivery’ was published recently in the international journal BMJ Open.
Every year, one-in-eight people aged 70 and over in Ireland require medical attention for a fall, while one-in-16 attend an emergency department following a fall. This equates to almost 62,000 older people requiring medical care for a fall annually, with over 32,000 presenting to emergency departments.
Falls are the most common cause of fractures, and a major contributor to reduced mobility and loss of independence. If falls are not prevented following an accident, the person falling will have further falls. Despite this, the study highlights significant gaps in both prevention and access to specialist services.
Key findings from TILDA include:
- One-in-eight older people (12 per cent) required medical attention for a fall in a 12-month period.
- One-in-16 (6 per cent) attended an emergency department because of a fall, which means over 32,000 older adults nationwide.
- Remarkably, over half of older people presenting to the emergency department with a fall were prescribed medications proven to increase the risk of falls, such as drugs that affect balance, alertness or blood pressure, illustrating a lack of awareness by the healthcare providers in emergency departments.
- Notably, over one-in-five older people who required medical attention for a fall have no access to a falls assessment clinic.
Ireland has the fastest-ageing population in the EU. Falls are already the most common reason for older people to be admitted to hospital. Ireland’s ageing population means that the number of falls will rise substantially in the coming decades. Most falls are preventable through medication review, cardiovascular assessment, and strength and balance exercises.
Prof Rose Anne Kenny, Head of Medical Gerontology at Trinity College Dublin and Principal Investigator of TILDA, added: “Falls can be prevented, and yet, poor prevention and treatment approach for falls is concerning. However, as health services are being reorganised regionally, we have an opportunity to address this escalating problem for all. This will reduce avoidable injury, hospital admissions and loss of independence in the majority.”
The authors note that Ireland currently has no national falls prevention strategy, despite strong international evidence that coordinated, multidisciplinary approaches can significantly reduce falls, fractures and pressure on emergency departments. They argue that improving access to dedicated falls clinics, systematically reviewing falls-risk-increasing medications, and investing in prevention programmes should be central to planning services for an ageing population.
