Falls in Older People: Risk Factors and Strategies
for Prevention. By Stephen R. Lord, Catherine
Sherrington, and Hylton B. Menz. 249 pages, illustrated.
Cambridge University Press, Cambridge, England,
2001. $50.00
In recent years interest in the subject of falls has increased, especially with regard to older adults. With the proportion of the population 65 years of age and older increasing rapidly throughout the developed world, the subject is of growing importance, as falls are the leading cause of injury-related hospitalization in this age group, accounting for 4% of all hospital admissions. This book is designed for health practitioners who participate in the care of older people, providing them with a detailed analysis of recent developments in the study of falls. Bridging the gap between scientific articles and textbooks, it considers the epidemiology of falls and fall-related injuries, environmental factors, the role of footwear, the relationship of medication to falling, evidence-based risk assessment, and prevention strategies. The authors are all affiliated with universities in Sydney, Australia, representing the disciplines of physiology, physiotherapy, biomechanics, and gerontology.
Falls have many causes, and the various aspects of human function and pathology that may contribute to falls are discussed. Several sections of the text emphasize that foot problems are among the major factors, but the authors note that falls and foot problems are generally poorly defined in epidemiologic studies and that additional research is required to clarify the role of foot disorders in this health problem. Also highlighted is the role of inadequate footwear in falls, with identification of various types of shoes meant for indoor and outdoor wear and analysis of the effect of footwear on balance. The roles of osteoarthritis, diabetes mellitus, peripheral vascular disease, and dermatologic conditions in falls are discussed, as well as the effects of diminished peripheral sensation and joint malposition. Numerous references are cited, including scores of articles from the podiatric medical and orthopedic literature.
The authors have summarized relatively concisely a considerable amount of information reflecting the comprehensive scope of this very important health problem. Falls can have serious consequences, and the importance of their prevention is increasing with the changing demographics of the world population. It is essential that this subject receive more attention in the podiatric medical community as well as in podiatric medical education and training programs. This book constitutes an easy-to-read introduction to the risk factors and prevention of falls that provides much assistance with this integral part of the responsibilities of the podiatric physician.
