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Most common cause of Injury related death in elderly is ‘Fall’ Shweta Dhamani Keswani

 Falls in elderly is common and constitute an important public health problem. According to WHO, fall is the second leading cause of injury-related death in elderly population. Department Of trade and Industry in UK in 1993 mentioned that  falls are the commonest cause of injury related death in persons over 75 years if age.
With appropriate physiotherapy treatment patient resumes their activities of daily living (ADLs) at the earliest. However, as a physiotherapist, Shweta Dhamani Keswani said that these people live with a fear of fall and anxiety about normal activities.
It is found that about one-third of elderly develop a fear of fall after a fall (Vellas BJ, 97) Those who develop a fear of fall had increased risk of falling, dependence and decreased quality of life (Cumming RG, 2000).
What is a fall? 
According to the International Classification of Diseases (ICD9), a fall is an unexpected event where a person falls to the ground from a higher level or same level. 
Some of modifiable risk factors 
- Limitations in mobility
- Impaired walking and balance
- Reduced leg and grip strength
- Reduced tactile and proprioceptive inputs from lower extremity
- Visual and vestibular disturbances
- Use of multiple medications
- Inadequate lighting, slippery floors, cluttered spaces, use of ladders etc.
What are the steps, as a society, we can take to prevent falls?  
Comprehensive Geriatric assessment- this includes complete physical, mental, social, economic, functional and environment assessment.
Physiotherapeutic assessment- performance based assessment of gait, balance and ADLs
Physiotherapeutic and Aquatic Therapy-  
Range of motion exercises to improve mobility
Strength training to improve bone mass, posture and gait
Proprioception and coordination exercises to improve balance
Habituation exercises to improve vestibular and balance disturbances
Endurance exercises to improve cardiorespiratory functions
Educational programs to increase awareness of 
- Knowledge of age related changes in body
- Identification of risk factors of falling
- Importance of safe access for elderly
- Use of grab bars and anti-skid surfaces especially in wash areas
- Use of stick or cane to improve balance.

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