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Preventing falls and fall-related injury in older people: how GPs can help

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Abstract
Falls and fall-related injury are common in older people, with some events having a direct impact on the person’s ability to function and live independently. There is good evidence that falls and fall-related injury can be prevented, and GPs have a key role in screening, assessment and implementing effective intervention strategies.
Key Points
  • GPs have a key role in screening and assessment of risk for falls in older people.
  • GPs have direct responsibility for medication use and the prescription of drugs that both increase and decrease risk of falls and fractures.
  • Medications to be avoided in the older person where possible are the centrally acting medications, especially sedative hypnotics, antidepressants, antipsychotics and opiate-containing analgesics.
  • Exercises that challenge balance are important for falls prevention and must be undertaken on an ongoing basis. The benefits of appropriate exercise should be conveyed to patients, particularly to those who have chronic diseases for which different approaches to exercise are required.
  • Residents in residential aged care should be seen as at high risk of falls. At a very minimum, all residents should be vitamin D replete. Several additional strategies can be used to reduce both falls and fracture risk.
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