Many different factors contribute to falls. The most significant risk is ageing with falls frequency and risk of injury potentially increasing.^2,3

Poor balance can occur because of declines and changes in sensory systems, the nervous system, or muscles. Non-specific ‘dizziness’ and vestibular disorders are commonly reported, but patients may need to explain the sensation in more detail.⁵

Other risk factors include:^{2,3,4,5,7,8,9}

·      a previous history of falls;

·      physical inactivity, reduced muscle strength, sarcopenia;

·      frailty;

·      reduced calorie or fluids intake;

·      medication;

·      cardiovascular conditions (eg orthostatic/postural hypotension);

·      delirium;

·      dementia and mild cognitive impairment (falls risk can double);

·      pain, particularly from arthritis, cancer related pain, and past-stroke pain;

·      diabetes (neuropathy or medicines-related hypoglycaemia):

·      depression (whether untreated or using antidepressants);

·      Parkinson’s disease and similar conditions;

·      impaired vision (eg due to outdated glasses prescription, needing glasses, cataracts or vision loss);

·      impaired hearing (possibly due to co-existent vestibular disease or loss of spatial awareness);

·      urinary incontinence (particularly urgency/stress incontinence or nocturia);

·      alcohol or substance use;

·      environmental hazards.

Globally, older women are especially prone to falls, but males consistently sustain higher death rates and disability-adjusted life years (DALYs) lost, possibly due to higher levels of risk-taking behaviours or hazardous occupations.⁷