Falls and function. How to prevent falls and injuries in patients with impaired mobility.

Older persons, particularly those with compromised health, are at increased risk of falls, and these events can significantly affect a person's quality of life. Risk factors include age, neurologic and musculoskeletal conditions, decreased physical strength, foot disorders, and use of medications or alcohol. When evaluating a patient who has fallen, physicians should be on the alert for intrinsic pathologies or situational conditions that place an older patient at increased risk for these incidents. Physical examination should include consideration of postural vital signs, polypharmacy, and sensory decline. Performance assessments are excellent tools for observing the status of gait and balance. Proper documentation and evaluation of a fall is a key step in preventive management.