Falls among elderly nursing home residents.

The purpose of this study was to measure the rate of falls and to identify the causes, consequences and opportunities for preventing falls among 796 permanent residents of a nursing home. Altogether 377 falls were reported among 207 residents during the study period. The most important association discovered was that between impaired visual acuity and falls. In addition, 49% of the fallers suffered from severe and 19% from mild dementia. In the group of demented subjects it was impossible to assess visual acuity in 30% of the fallers as the subjects were unable to fixate at request. This finding may be one explanation for the increased incidence of falls in demented subjects. We conclude that the high number of subjects suffering from dementia among institutionalized elderly limits the possibility of training in prevention. The main emphasis in prevention of falls in institutions should be in proper design of the environment, including the visual environment.