Falls

Falls in older people are very common and for some the consequences can be devastating. The clinical assessment, management and investigation of patients who present with falls can be challenging for the non-specialist, and multiple guidelines and algorithms have been published to aid that process. This article has been prepared as a concise reference that reviews the most recent evidence and covers the medical competencies on falls outlined in the Curriculum for General Internal Medicine (Acute) of the Federation of Royal Colleges of Physicians of the UK. As in the curriculum, the emphasis is on the acute setting. Important topics covered include the epidemiology of falls, definition and classification, causes and risk factors, cumulative effect of risk factors and the concept of individual falling threshold, physical and psychosocial consequences of falling, medical falls assessment in the acute setting, differentiation between falls and syncope, principles of multifactorial falls assessment and intervention, teamwork and communication skills, and evidence-based strategies for prevention, including the latest developments in falls prevention research.