Falls

Definition of falls

A fall is defined as an event which results in a person coming to rest inadvertently on the ground or floor or other lower level.¹

Impact of falls on Western Australia

Who does it impact?

In Western Australia:²

• in 2019, there were 354 falls-related fatalities.
• in 2020, there were 31,708 falls-related hospitalisations.
• in 2020, there were 42,160 falls-related emergency department attendances.

In Western Australia between 2015 and 2019 there were:³

• 138,537 hospitalisations due to falls.
• 55.7% of hospitalisations for falls were females.
• people aged 65+ years had the highest incidence of falls.

In Western Australia Aboriginal peoples make up 3.1% of the population, however between 2011 and 2015 5.19% of falls hospitalisations were Aboriginal people.^3,4

Where does it occur?

In Western Australia, between 2015 and 2019, the three regions with the greatest difference in regional hospitalisation rates compared to the WA State hospitalisation rate, were the Kimberley (118% higher), Midwest (17% higher) and Wheatbelt (12% higher).³

Impact on health system

In Western Australia in 2019, there were 29,866 hospitalisations for falls, consuming an estimated 200,810 bed days at an approximate cost of $267,328,478.³

Determinants of Falls

Age and gender

Developmental changes among children and older adults places these age groups at an increased risk of experiencing a fall. In Western Australia the rate of hospitalisations and deaths due to falls is at the highest level among people over 65 years of age.²

Mobility

Muscle weakness and pain when walking can have a negative impact on an individual’s mobility. This places them at a higher risk of falls due to their negative effect on postural sway, gait velocity, stride length, step height, reaction time, visual acuity and depth perception.¹

Environmental hazards

There are a range of environmental hazards that have the potential to increase an individual’s risk of falling including stairs, loose rugs and cords, poor lighting, furniture height, uneven surfaces and slippery floor surfaces.¹

Medications

Specific drugs including antidepressants, sedatives and antihypertensives have been connected to an increased risk of falling. Also, the use of multiple medications (polypharmacy), inappropriate prescribing, misuse and inappropriate dosage can influence an individual’s risk of falling.¹

Footwear

An individual’s risk of having a fall is increased when wearing footwear that has no support, has worn soles, heels or a slippery surface.¹  

Eyesight

Vision-related factors including reduced contrast sensitivity, reduced depth perception, reduced visual field and incorrect prescriptions can increase an individual’s risk of a fall.⁵

History of falling

If an individual has experienced a fall they are at a higher risk of having another fall in the future.¹ This increased risk has been associated with a fear of falling, a lack of confidence in the individual’s ability to carry out everyday activities and the negative impact that the fear of falling can have on the individual’s activity levels.

Effective Interventions

Australian standards for falls amongst children

There are a number of Australian Standards that aim to support the minimisation of injury risk to children. Including policies and standards regarding playground equipment, pathways, furniture and pedal cycle helmets.

Falls prevention education and awareness campaigns

Initiatives for health professionals and community members focusing on raising awareness and increase their knowledge of falls prevention behaviours is beneficial. Outlining the importance of identifying any falls risk factors as soon as possible, how falls risk factors can be minimised and highlighting specialist services that are available if required are valuable falls prevention activities.¹

Western Australian example: Stay On Your Feet^® is a falls prevention program that aims to promote healthy, active ageing in Western Australia to reduce falls among older people. The program does this by raising awareness of the risk factors for falls in older people with community members, health professionals and other service providers.

Falls prevention programs in hospitals

Hospital-based multicomponent interventions, exercise programs and education programs are key components towards an effective falls prevention initiative.¹

Western Australian example: Specialty medical clinics, falls prevention education classes, home-based Falls Risk Assessments and Falls Prevention Programmes are provided by Sir Charles Gairdner Hospital. The initiatives run by Sir Charles Gairdner Hospital target their staff, patients and community members.

Individual actions

On an individual level there are a number of actions that can be taken to decrease an individual’s falls risk including; removing hazards, wearing safe footwear, getting eyesight checked regularly, eating a balanced diet, keeping a healthy mind, regularly getting medications checked, building their balance and strengthening their legs.¹

Western Australian example: Kidsafe WA run a Safety Demonstration House and Resource Centre in Perth, which displays situations around the house that could be hazardous for young children and a range of prevention methods that individuals can implement to reduce the risk of injury.

Organisations and programs in Western Australia

Injury Matters Falls Resources

Other Resources

AIHW, Trends in hospitalised injury due to falls in older people 2007-08 to 2016-17

ANZ Falls Prevention Society, Why investing in falls prevention across Australia can’t wait

East Metropolitan Health Service, Falls admissions to Royal Perth Hospital since 2010

East Metropolitan Health Service, 10 years of admissions from ladder/roof-related falls

Kidsafe WA, Falls WA Childhood Injury Bulletin

Preventing Falls and Harm From Falls in Older People: Best Practice Guidelines for Australian Community Care

WA Department of Health, Falls Prevention Model of Care

WHO, Global Report on Falls Prevention in Older Age

WHO, Step Safely: Strategies for preventing and managing falls across the life course

References

1. World Health Organization. Step safely: strategies for preventing and managing falls across the life-course. (2021).
2. Sweeney, R. & Menezes, S. 2022 Western Australian Falls Report. (2022).
3. Data generated using HealthTracks Reporting, by the Epidemiology Branch, WA Department of Health in collaboration with the Cooperative Research Centre for Spatial Information (CRC-SI), March, 2021.
4. Australian Bureau of Statistics. Australian Bureau of Statistics. Western Australia, People www.censusdata.abs.gov.au/census_services/getproduct/census/2016/quickstat/5?opendocument (2017).
5. Saftari, L. N. & Kwon, O.-S. Ageing vision and falls: a review. J Physiol Anthropol37, 11 (2018).