Since january 1st of this year, people over 65 years old had a fall in Europe, sometimes with serious consequences.
Since january 1st of this year, people over 65 years old had a fall in Europe, sometimes with serious consequences.
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Falls are often the result of an interaction between various risk factors relating to ageing, the environment or physical condition. The combination of these factors can vary for each individual and be different for each fall. This explains why it can sometimes be difficult, after a fall, to find its cause.
The more a person cumulates fall risk factors, the more likely the fall is to be triggered by a minor cause.
- Mechanical causes represent 50% of the causes of falls.
- As we age, other causes become increasingly important. They can be divided into three main groups.
Falls can be associated with a syncope, i.e. low blood flow which is hard to tolerate for the brain.
All cardiac ailments which can cause low blood flow to the brain can therefore lead to falls: supraventricular rhythm disorders, conduction disorders, myocardial infarction, pulmonary embolism, aortic stenosis, etc. In 40% of cases, the cause of the syncope cannot be found but, according to a study by Rebenstein, it is most often benign.
Among vascular causes, orthostatic hypotension, which is involved in 10 to 15% of falls, is the most frequent by far. It is usually multifactorial (hypovolaemia, venous insufficiency in the lower limbs, autonomic nervous system dysfunction, being no longer used to physical effort, postprandial hypotension, etc.), but in most cases, one of the drugs used by the person can be held responsible.
For more information:
- a drop in blood pressure is associated with an increase in falls. (Aronov)
- there are less falls among hypertensives. (Herndon)
They most often involve cerebrovascular accidents, but a seizure or subdural hematoma can also lead to a fall. The cause is often easy to diagnose because the fall is not the only element leading to the diagnosis. Confusional episodes put seniors at risk by impairing their vigilance.
The most frequent is hypoglycaemia, i.e. low blood sugar level which is hard to tolerate for the brain.
Hypokalemia and hyperkalemia are responsible for paroxysmal disorders of heart rhythm and hypercalcaemia among seniors often results in confusion or vigilance disorders which can be conducive to falls.
