Falls can be caused by physical conditions that impair mobility or balance, hazards in the environment, or potentially hazardous situations. Most falls occur when several causes interact. For example, people with Parkinson disease and impaired vision (physical conditions) may trip on an extension cord (an environmental hazard) while rushing to answer the telephone (a potentially hazardous situation).
A person’s physical condition is affected by changes due to aging itself, physical fitness, disorders present, and drugs used. The physical condition probably has a greater effect on the risk of falling than do environmental hazards and hazardous situations. Not only does a poor or impaired physical condition increase the risk of falls, but it also affects how people respond to hazards and hazardous situations.
Physical impairments that increase the risk of falling include those involving
Balance or walking
Sensation, particularly in the feet
Blood pressure or heartbeat
Use of drugs that affect attention (for example, opioid analgesics, antianxiety drugs, and some antidepressant drugs) or lower blood pressure (for example, antihypertensive, diuretic, and some heart drugs) can also increase the risk of falling.
Hazards in the environment are involved in many falls. Falls may occur when people do not notice a hazard or do not respond quickly enough after a hazard is noticed.
Environmental hazards that increase the risk of falling include
Electrical or extension cords or objects that are in the way of walking
Uneven sidewalks and broken curbs
Unfamiliarity with surroundings
Most falls occur indoors. Some happen while people are standing still. But most occur while people are moving—getting in or out of bed or a chair, getting on or off a toilet seat, walking, or going up or down stairs. While moving, people may stumble or trip, or balance may be lost. Any movement can be hazardous. But if people are rushing or if their attention is divided, movement becomes even more hazardous. For example, rushing to the bathroom (especially at night when not fully awake or when lighting may be poor) or to answer the telephone or talking on a cordless phone can make walking more hazardous.