Objective: To review the epidemiology and causes of falls and
fall-related injuries in nursing homes and to provide clinicians
with a structured framework to evaluate and treat nursing home
residents at risk for falls. Data Sources: All large-scale
published studies documenting incidence, causes, risk factors,
and preventive strategies for falls in nursing homes were
reviewed. Results: The mean incidence of falls in nursing homes
is 1.5 falls per bed per year (range, 0.2 to 3.6 falls). The
most common precipitating causes include gait and balance
disorders, weakness, dizziness, environmental hazards,
confusion, visual impairment, and postural hypotension. The most
important underlying risk factors for falls and injuries include
some of these same items and others, such as lower-extremity
weakness, gait and balance instability, poor vision, cognitive
and functional impairment, and sedating and psychoactive
medications. Many strategies for the prevention of falls have
been tried, with mixed success. The most su