Skip to main content Accessibility help
Hostname: page-component-5959bf8d4d-2zkqf Total loading time: 1.048 Render date: 2022-12-09T21:07:01.117Z Has data issue: true Feature Flags: { "useRatesEcommerce": false } hasContentIssue true

9 - The Psychology of Fall Risk: Fear, Anxiety, Depression, and Balance Confidence

from Part I - Epidemiology and Risk Factors for Falls

Published online by Cambridge University Press:  04 November 2021

Stephen R. Lord
Neuroscience Research Australia, Sydney
Catherine Sherrington
Sydney Medical School
Vasi Naganathan
Concord Hospital
Get access


Originally discussed in early clinical reports (e.g. [1]), the relationship between psychological factors and falls is now well supported in the literature. Specifically, fear of falling, balance confidence or fall efficacy (i.e. belief in ability to maintain one’s balance),1 and depression are well-established predictors of falls and determinants of fall risk (e.g. [4,5]). Anxiety also appears to play a role in the determination of balance performance and gait parameters [6]. These psychological variables, which can also be the consequence of or be changed by a fall, can lead to activity avoidance in an effort to prevent future injuries [7]. In this chapter, psychological risk and consequences of falls and interventions designed to address them are discussed.

Falls in Older People
Risk Factors, Strategies for Prevention and Implications for Practice
, pp. 160 - 171
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th Edn. Arlington, VA: American Psychiatric Association; 2013.Google Scholar
World Health Organization. Dementia. 2019 (accessed April 2021).Google Scholar
Alzheimer’s Disease International, Prince, M, Wimo, A, Guerchet, M et al. World Alzheimer Report 2015. (accessed April 2021).Google Scholar
Allan, LM, Ballard, CG, Rowan, EN et al. Incidence and prediction of falls in dementia: a prospective study in older people. PLoS ONE. 2009;4:e5521.CrossRefGoogle ScholarPubMed
Tinetti, ME, Speechley, M, Ginter, SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319:1701–7.CrossRefGoogle ScholarPubMed
Anstey, KJ, von Sanden, C, Luszcz, MA. An 8-year prospective study of the relationship between cognitive performance and falling in very old adults. J Am Geriatr Soc. 2006;54:1169–76.CrossRefGoogle ScholarPubMed
Asada, T, Kariya, T, Kinoshita, T et al. Predictors of fall-related injuries among community-dwelling elderly people with dementia. Age Ageing. 1996;25:22–8.CrossRefGoogle ScholarPubMed
Taylor, ME, Delbaere, K, Lord, SR et al. Physical impairments in cognitively impaired older people: implications for risk of falls. Int Psychogeriatr. 2013;25:148–56.CrossRefGoogle ScholarPubMed
Petersen, JD, Siersma, VD, Christensen, RD et al. The risk of fall accidents for home dwellers with dementia: a register- and population-based case-control study. Alzheimers Dement. 2018;10:421–8.Google ScholarPubMed
Baker, NL, Cook, MN, Arrighi, HM et al. Hip fracture risk and subsequent mortality among Alzheimer’s disease patients in the United Kingdom, 1988–2007. Age Ageing. 2011;40:4954.CrossRefGoogle ScholarPubMed
Harvey, L, Mitchell, R, Brodaty, H et al. The influence of dementia on injury-related hospitalisations and outcomes in older adults. Injury. 2016;47:226–34.CrossRefGoogle ScholarPubMed
Harvey, L, Mitchell, R, Brodaty, H et al. Differing trends in fall-related fracture and non-fracture injuries in older people with and without dementia. Arch Gerontol Geriatr. 2016;67:61–7.CrossRefGoogle ScholarPubMed
Weller, I, Schatzker, J. Hip fractures and Alzheimer’s disease in elderly institutionalized Canadians. Ann Epidemiol. 2004;14:319–24.CrossRefGoogle ScholarPubMed
Cree, M, Soskolne, CL, Belseck, E et al. Mortality and institutionalization following hip fracture. J Am Geriatr Soc. 2000;48:283–8.CrossRefGoogle ScholarPubMed
Marottoli, RA, Berkman, LF, Leo-Summers, L et al. Predictors of mortality and institutionalization after hip fracture: the New Haven EPESE cohort. Established Populations for Epidemiologic Studies of the Elderly. Am J Public Health. 1994;84:1807–12.CrossRefGoogle ScholarPubMed
Poynter, L, Kwan, J, Sayer, AA et al. Does cognitive impairment affect rehabilitation outcome? J Am Geriatr Soc. 2011;59:2108–11.CrossRefGoogle ScholarPubMed
Scandol, JP, Toson, B, Close, JC. Fall-related hip fracture hospitalisations and the prevalence of dementia within older people in New South Wales, Australia: an analysis of linked data. Injury. 2012;44:776–83.Google ScholarPubMed
Gruber-Baldini, AL, Zimmerman, S, Morrison, RS et al. Cognitive impairment in hip fracture patients: timing of detection and longitudinal follow-up. J Am Geriatr Soc. 2003;51:1227–36.CrossRefGoogle ScholarPubMed
Franssen, EH, Souren, LE, Torossian, CL et al. Equilibrium and limb coordination in mild cognitive impairment and mild Alzheimer’s disease. J Am Geriatr Soc. 1999;47:463–9.CrossRefGoogle ScholarPubMed
Leandri, M, Cammisuli, S, Cammarata, S et al. Balance features in Alzheimer’s disease and amnestic mild cognitive impairment. J Alzheimers Dis. 2009;16:113–20.CrossRefGoogle ScholarPubMed
Suttanon, P, Hill, KD, Said, CM et al. Balance and mobility dysfunction and falls risk in older people with mild to moderate Alzheimer disease. Am J Phys Med Rehabil. 2012;91:1223.CrossRefGoogle ScholarPubMed
Szczepańska-Gieracha, J, Cieślik, B, Chamela-Bilińska, D et al. Postural stability of elderly people with cognitive impairments. Am J Alzheimers Dis Other Demen. 2016;31:241–6.CrossRefGoogle ScholarPubMed
Taylor, ME, Lord, SR, Delbaere, K et al. Reaction time and postural sway modify the effect of executive function on risk of falls in older people with mild to moderate cognitive impairment. Am J Geriatr Psychiatry. 2017;25:397406.CrossRefGoogle ScholarPubMed
Horikawa, E, Matsui, T, Arai, H et al. Risk of falls in Alzheimer’s disease: a prospective study. Intern Med J. 2005;44:717–21.Google ScholarPubMed
Taylor, ME, Delbaere, K, Lord, SR et al. Neuropsychological, physical, and functional mobility measures associated with falls in cognitively impaired older adults. J Gerontol A Biol Sci Med Sci. 2014;69:987–95.CrossRefGoogle ScholarPubMed
Whitney, J, Close, JC, Jackson, SH et al. Understanding risk of falls in people with cognitive impairment living in residential care. J Am Med Dir Assoc. 2012;13:535–40.CrossRefGoogle ScholarPubMed
Hauer, K, Dutzi, I, Gordt, K et al. Specific motor and cognitive performances predict falls during ward-based geriatric rehabilitation in patients with dementia. Sensors. 2020;20:5385.CrossRefGoogle ScholarPubMed
Beauchet, O, Annweiler, C, Callisaya, ML et al. Poor gait performance and prediction of dementia: results from a meta-analysis. J Am Med Dir Assoc. 2016;17:482–90.CrossRefGoogle ScholarPubMed
Valkanova, V, Ebmeier, KP. What can gait tell us about dementia? Review of epidemiological and neuropsychological evidence. Gait Posture. 2017;53:215–23.CrossRefGoogle ScholarPubMed
Mc Ardle, R, Morris, R, Wilson, J et al. What can quantitative gait analysis tell us about dementia and its subtypes? A structured review. J Alzheimers Dis. 2017;60:1295–312.CrossRefGoogle ScholarPubMed
Camicioli, R, Licis, L. Motor impairment predicts falls in specialized Alzheimer care units. Alzheimer Dis Assoc Disord. 2004;18:214–18.Google ScholarPubMed
Nakamura, T, Meguro, K, Sasaki, H. Relationship between falls and stride length variability in senile dementia of the Alzheimer type. Gerontology. 1996;42:108–13.CrossRefGoogle ScholarPubMed
Sterke, CS, van Beeck, EF, Looman, CW et al. An electronic walkway can predict short-term fall risk in nursing home residents with dementia. Gait Posture. 2012;36:95101.CrossRefGoogle ScholarPubMed
Taylor, ME, Delbaere, K, Mikolaizak, AS et al. Gait parameter risk factors for falls under simple and dual task conditions in cognitively impaired older people. Gait Posture. 2013;37:126–30.CrossRefGoogle ScholarPubMed
Taylor, ME, Ketels, MM, Delbaere, K et al. Gait impairment and falls in cognitively impaired older adults: an explanatory model of sensorimotor and neuropsychological mediators. Age Ageing. 2012;41:665–9.CrossRefGoogle ScholarPubMed
Mehdizadeh, S, Dolatabadi, E, Ng, K-D et al. Vision-based assessment of gait features associated with falls in people with dementia. J Gerontol A Biol Sci Med Sci. 2019;75:1148–53.Google Scholar
Beurskens, R, Bock, O. Age-related deficits of dual-task walking: a review. Neural Plast. 2012;2012:19.CrossRefGoogle ScholarPubMed
Allali, G, Kressig, RW, Assal, F et al. Changes in gait while backward counting in demented older adults with frontal lobe dysfunction. Gait Posture. 2007;26:572–6.CrossRefGoogle ScholarPubMed
Lamoth, CJ, van Deudekom, FJ, van Campen, JP et al. Gait stability and variability measures show effects of impaired cognition and dual tasking in frail people. J Neuroeng Rehabil. 2011;8:2.CrossRefGoogle ScholarPubMed
Amboni, M, Barone, P, Hausdorff, JM. Cognitive contributions to gait and falls: evidence and implications. Mov Disord. 2013;28:1520–33.CrossRefGoogle ScholarPubMed
Gonçalves, J, Ansai, JH, Masse, FAA et al. Dual-task as a predictor of falls in older people with mild cognitive impairment and mild Alzheimer’s disease: a prospective cohort study. Braz J Phys Ther. 2018;22:417–23.CrossRefGoogle ScholarPubMed
Booth, V, Logan, P, Masud, T et al. Falls, gait, and dual-tasking in older adults with mild cognitive impairment: a cross-sectional study. Eur Geriatr Med. 2015:S32156.CrossRefGoogle Scholar
Eriksson, S, Gustafson, Y, Lundin-Olsson, L. Risk factors for falls in people with and without a diagnose of dementia living in residential care facilities: a prospective study. Arch Gerontol Geriatr. 2008;46:293306.CrossRefGoogle ScholarPubMed
Forsell, Y, Winblad, B. Psychiatric disturbances and the use of psychotropic drugs in a population of nonagenarians. Int J Geriatr Psychiatry. 1997;12:533–6.3.0.CO;2-X>CrossRefGoogle Scholar
Giron, MST, Forsell, Y, Bernsten, C et al. Psychotropic drug use in elderly people with and without dementia. Int J Geriatr Psychiatry. 2001;16:900–6.CrossRefGoogle ScholarPubMed
Lesén, E, Carlsten, A, Skoog, I et al. Psychotropic drug use in relation to mental disorders and institutionalization among 95-year-olds: a population-based study. Int Psychogeriatr. 2011;23:1270–7.CrossRefGoogle ScholarPubMed
Torvinen-Kiiskinen, S, Tolppanen, AM, Koponen, M et al. Antidepressant use and risk of hip fractures among community-dwelling persons with and without Alzheimer’s disease. Int J Geriatr Psychiatry. 2017;32:e107–15.CrossRefGoogle ScholarPubMed
Eriksson, S, Lundquist, A, Gustafson, Y et al. Comparison of three statistical methods for analysis of fall predictors in people with dementia: negative binomial regression (NBR), regression tree (RT), and partial least squares regression (PLSR). Arch Gerontol Geriatr. 2009;49:383–9.CrossRefGoogle Scholar
Kröpelin, TF, Neyens, JCL, Halfens, RJG et al. Fall determinants in older long-term care residents with dementia: a systematic review. Int Psychogeriatr. 2013;25:549–63.CrossRefGoogle ScholarPubMed
Pellfolk, T, Gustafsson, T, Gustafson, Y et al. Risk factors for falls among residents with dementia living in group dwellings. Int Psychogeriatr. 2009;21:187–94.CrossRefGoogle ScholarPubMed
Hart, LA, Marcum, ZA, Gray, SL et al. The association between central nervous system-active medication use and fall-related injury in community-dwelling older adults with dementia. Pharmacotherapy. 2019;39:530–43.CrossRefGoogle ScholarPubMed
Taipale, H, Hamina, A, Karttunen, N et al. Incident opioid use and risk of hip fracture among persons with Alzheimer disease: a nationwide matched cohort study. Pain. 2019;160:417–23.CrossRefGoogle ScholarPubMed
Salva, A, Roque, M, Rojano, X et al. Falls and risk factors for falls in community-dwelling adults with dementia (NutriAlz Trial). Alzheimer Dis Assoc Disord. 2012;26:7480.CrossRefGoogle Scholar
Sofi, F, Valecchi, D, Bacci, D et al. Physical activity and risk of cognitive decline: a meta-analysis of prospective studies. J Intern Med. 2011;269:107–17.CrossRefGoogle ScholarPubMed
Stephen, R, Hongisto, K, Solomon, A et al. Physical activity and Alzheimer’s disease: a systematic review. J Gerontol A Biol Sci Med Sci. 2017;72:733–9.Google ScholarPubMed
Taylor, ME, Boripuntakul, S, Toson, B et al. The role of cognitive function and physical activity in physical decline in older adults across the cognitive spectrum. Aging Ment Health. 2019;23:863–71.CrossRefGoogle ScholarPubMed
Sackley, C, Levin, S, Cardoso, K et al. Observations of activity levels and social interaction in a residential care setting. Int J Ther Rehabil. 2006;13:370–3.CrossRefGoogle Scholar
Passant, U, Warkentin, S, Gustafson, L. Orthostatic hypotension and low blood pressure in organic dementia: a study of prevalence and related clinical characteristics. Int J Geriatr Psychiatry. 1997;12:395403.3.0.CO;2-#>CrossRefGoogle ScholarPubMed
Kenny, RA, Shaw, FE, O’Brien, JT et al. Carotid sinus syndrome is common in dementia with Lewy bodies and correlates with deep white matter lesions. J Neurol Neurosurg Psychiatry. 2004;75:966–71.CrossRefGoogle ScholarPubMed
Taylor, ME, Lord, SR, Delbaere, K et al. White matter hyperintensities are associated with falls in older people with dementia. Brain Imaging Behav. 2019;13:1265–72.CrossRefGoogle ScholarPubMed
Olsson, RH, Jr., Wambold, S, Brock, B et al. Visual spatial abilities and fall risk: an assessment tool for individuals with dementia. J Gerontol Nurs. 2005;31:4551;quiz 23.CrossRefGoogle ScholarPubMed
Cipriani, G, Lucetti, C, Nuti, A et al. Wandering and dementia. Psychogeriatrics. 2014;14:135–42.CrossRefGoogle ScholarPubMed
Hasegawa, J, Kuzuya, M, Iguchi, A. Urinary incontinence and behavioral symptoms are independent risk factors for recurrent and injurious falls, respectively, among residents in long-term care facilities. Arch Gerontol Geriatr. 2010;50:7781.CrossRefGoogle ScholarPubMed
Kallin, K, Gustafson, Y, Sandman, PO et al. Factors associated with falls among older, cognitively impaired people in geriatric care settings: a population-based study. Am J Geriatr Psychiatry. 2005;13:501–9.CrossRefGoogle ScholarPubMed
Stapleton, C, Hough, P, Oldmeadow, L et al. Four-item fall risk screening tool for subacute and residential aged care: the first step in fall prevention. Australas J Ageing. 2009;28:139–43.CrossRefGoogle Scholar
Thapa, PB, Gideon, P, Fought, RL et al. Psychotropic drugs and risk of recurrent falls in ambulatory nursing home residents. Am J Epidemiol. 1995;142:202–11.CrossRefGoogle ScholarPubMed
Roitto, H-M, Öhman, H, Salminen, K et al. Neuropsychiatric symptoms as predictors of falls in long-term care residents with cognitive impairment. J Am Med Dir Assoc. 2020;21:1243–8.CrossRefGoogle ScholarPubMed
Roitto, HM, Kautiainen, H, Ohman, H et al. Relationship of neuropsychiatric symptoms with falls in Alzheimer’s disease: does exercise modify the risk? J Am Geriatr Soc. 2018;66:2377–81.CrossRefGoogle ScholarPubMed
Buchner, DM, Larson, EB. Falls and fractures in patients with Alzheimer-type dementia. J Am Med Assoc. 1987;257:1492–5.CrossRefGoogle ScholarPubMed
Fernando, E, Fraser, M, Hendriksen, J et al. Risk factors associated with falls in older adults with dementia: a systematic review. Physiother Can. 2017;69:161–70.CrossRefGoogle ScholarPubMed
Enache, D, Winblad, B, Aarsland, D. Depression in dementia: epidemiology, mechanisms, and treatment. Curr Opin Psychiatry. 2011;24:461–72.CrossRefGoogle Scholar
Cherbuin, N, Kim, S, Anstey, KJ. Dementia risk estimates associated with measures of depression: a systematic review and meta-analysis. BMJ Open. 2015;5:e008853.CrossRefGoogle ScholarPubMed
Seignourel, PJ, Kunik, ME, Snow, L et al. Anxiety in dementia: a critical review. Clin Psychol Rev. 2008;28:1071–82.CrossRefGoogle ScholarPubMed
Taylor, ME, Butler, AA, Lord, SR et al. Inaccurate judgement of reach is associated with slow reaction time, poor balance, impaired executive function and predicts prospective falls in older people with cognitive impairment. Exp Gerontol. 2018;114:50–6.CrossRefGoogle ScholarPubMed
Butler, AA, Lord, SR, Fitzpatrick, RC. Reach distance but not judgment error is associated with falls in older people. J Gerontol A Biol Sci Med Sci. 2011;66:896903.CrossRefGoogle Scholar
Sherrington, C, Fairhall, NJ, Wallbank, GK et al. Exercise for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2019;1:CD012424.Google ScholarPubMed
Hopewell, S, Adedire, O, Copsey, BJ et al. Multifactorial and multiple component interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2018;7:CD012221.Google ScholarPubMed
Sherrington, C, Michaleff, ZA, Fairhall, N et al. Exercise to prevent falls in older adults: an updated systematic review and meta-analysis. Br J Sports Med. 2016;51:1750–8.Google ScholarPubMed
Burton, E, Cavalheri, V, Adam, R et al. Effectiveness of exercise programs to reduce falls in older people with dementia living in the community: a systematic review and meta-analysis. Clin Interv Aging. 2015;10:421–34.Google ScholarPubMed
Pitkäla, KH, Pöysti, MM, Laakkonen, ML et al. Effects of the Finnish Alzheimer Disease Exercise Trial (FINALEX): a randomized controlled trial. JAMA Intern Med. 2013;173:894901.CrossRefGoogle ScholarPubMed
Öhman, H, Savikko, N, Strandberg, T et al. Effects of exercise on functional performance and fall rate in subjects with mild or advanced Alzheimer’s disease: secondary analyses of a randomized controlled study. Dem Geriatr Cogn Disord. 2016;41:233–41.Google ScholarPubMed
Taylor, ME, Wesson, J, Sherrington, C et al. Tailored exercise and home hazard reduction for fall prevention in older people with cognitive impairment: the i-FOCIS randomized controlled trial. J Gerontol A Biol Sci Med Sci. 2021;76:655–65.CrossRefGoogle ScholarPubMed
Montero-Odasso, M, Speechley, M, Chertkow, H et al. Donepezil for gait and falls in mild cognitive impairment: a randomized controlled trial. Eur J Neurol. 2019;26:651–9.CrossRefGoogle ScholarPubMed
Prince, M, Knapp, M, Guerchet, M et al. Dementia UK: 2nd Edn – Overview. London: Alzheimer’s Society; 2014.Google Scholar
Jensen, J, Nyberg, L, Gustafson, Y et al. Fall and injury prevention in residential care-effects in residents with higher and lower levels of cognition. J Am Geriatr Soc. 2003;51:627–35.CrossRefGoogle ScholarPubMed
Neyens, JC, Dijcks, BP, Twisk, J et al. A multifactorial intervention for the prevention of falls in psychogeriatric nursing home patients, a randomised controlled trial (RCT). Age Ageing. 2009;38:194–9.Google Scholar
Rapp, K, Sarah, EL, Gisela, B et al. Prevention of falls in nursing homes: subgroup analyses of a randomized fall prevention trial. J Am Geriatr Soc. 2008;56:1092–7.CrossRefGoogle ScholarPubMed
Rosendahl, E, Gustafson, Y, Nordin, E et al. A randomized controlled trial of fall prevention by a high-intensity functional exercise program for older people living in residential care facilities. Aging Clin Exp Res. 2008;20:6775.CrossRefGoogle ScholarPubMed
Vlaeyen, E, Coussement, J, Leysens, G et al. Characteristics and effectiveness of fall prevention programs in nursing homes: a systematic review and meta-analysis of randomized controlled trials. J Am Geriatr Soc. 2015;63:211–21.CrossRefGoogle ScholarPubMed
Cameron, ID, Dyer, SM, Panagoda, CE et al. Interventions for preventing falls in older people in care facilities and hospitals. Cochrane Database Syst Rev. 2018;2018: CD005465.Google Scholar
Hewitt, J, Goodall, S, Clemson, L et al. Progressive resistance and balance training for falls prevention in long-term residential aged care: a cluster randomized trial of the Sunbeam Program. J Am Med Dir Assoc. 2018;19:361–9.CrossRefGoogle Scholar
Bouwen, A, De Lepeleire, J, Buntinx, F. Rate of accidental falls in institutionalised older people with and without cognitive impairment halved as a result of a staff-oriented intervention. Age Ageing. 2008;37:306–10.CrossRefGoogle ScholarPubMed
Flicker, L, MacInnis, RJ, Stein, MS et al. Should older people in residential care receive vitamin D to prevent falls? Results of a randomized trial. J Am Geriatr Soc. 2005;53:1881–8.CrossRefGoogle ScholarPubMed
Sakamoto, Y, Ebihara, S, Ebihara, T et al. Fall prevention using olfactory stimulation with lavender odor in elderly nursing home residents: a randomized controlled trial. J Am Geriatr Soc. 2012;60:1005–11.CrossRefGoogle ScholarPubMed
Hewitt, J, Saing, S, Goodall, S et al. An economic evaluation of the SUNBEAM programme: a falls-prevention randomized controlled trial in residential aged care. Clin Rehabil. 2019;33:524–34.CrossRefGoogle ScholarPubMed
Toots, A, Wiklund, R, Littbrand, H et al. The effects of exercise on falls in older people with dementia living in nursing homes: a randomized controlled trial. J Am Med Dir Assoc. 2019;20:835–42.CrossRefGoogle ScholarPubMed
Alzheimer’s Society. Counting the Cost: Caring for People with Dementia on Hospital Wards. London: Alzheimer’s Society; 2009.Google Scholar
Young, J, Inouye, SK. Delirium in older people. Br Med J. 2007;334:842–6.CrossRefGoogle ScholarPubMed
Fogg, C, Griffiths, P, Meredith, P et al. Hospital outcomes of older people with cognitive impairment: an integrative review. Int J Geriatr Psychiatry. 2018;33:1177–97.CrossRefGoogle Scholar
Dykes, PC, Carroll, DL, Hurley, A et al. Fall prevention in acute care hospitals: a randomized trial. J Am Med Assoc. 2010;304:1912–18.CrossRefGoogle ScholarPubMed
Haines, TP, Bennell, KL, Osborne, RH et al. Effectiveness of targeted falls prevention programme in subacute hospital setting: randomised controlled trial. Br Med J. 2004;328:676.CrossRefGoogle ScholarPubMed
Healey, F, Monro, A, Cockram, A et al. Using targeted risk factor reduction to prevent falls in older in-patients: a randomised controlled trial. Age Ageing. 2004;33:390–5.CrossRefGoogle ScholarPubMed
Hshieh, TT, Yue, J, Oh, E et al. Effectiveness of multicomponent nonpharmacological delirium interventions: a meta-analysis. JAMA Intern Med. 2015;175:512–20.CrossRefGoogle ScholarPubMed
Haines, TP, Hill, AM, Hill, KD et al. Patient education to prevent falls among older hospital inpatients: a randomized controlled trial. Arch Intern Med. 2011;171:516–24.CrossRefGoogle ScholarPubMed
Hill, AM, McPhail, SM, Waldron, N et al. Fall rates in hospital rehabilitation units after individualised patient and staff education programmes: a pragmatic, stepped-wedge, cluster-randomised controlled trial. Lancet. 2015;385:2592–9.CrossRefGoogle ScholarPubMed
Stenvall, M, Olofsson, B, Lundstrom, M et al. A multidisciplinary, multifactorial intervention program reduces postoperative falls and injuries after femoral neck fracture. Osteoporos Int. 2007;18:167–75.CrossRefGoogle ScholarPubMed
Cited by

Save book to Kindle

To save this book to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the or variations. ‘’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats