Table 3.

Risk factors for falls and multifactorial interventions to prevent falls in community-dwelling older people (1, 6, 25)

Environmental risk factors
Lack of assistive devices	Obstacles in the walking paths
Loose throw rugs	Slippery conditions
Low level lighting
Medical risk factors
Age	Arrhythmias
Anxiety and agitation	Depression
Poor vision	Orthostatic hypotension
Dehydration	Previous falls or fear of falling
Medications causing sedation (narcotic analgesics, anticonvulsants, psychotropics	Reduced problem solving or mental acuity and diminished cognitive skills
Vitamin D insufficiency [serum 25-hydroxyvitamin D (25 (OH) D) <30 ng/mL (75 nmol/L)]	Urgent urinary incontinence
Malnutrition
Neurological and musculoskeletal risk factors
Kyphosis	Reduced proprioception
Impaired transfer and mobility	Weak muscles/sarcopenia
Poor balance
Deconditioning	Diseases listed in Table 1
Multifactorial interventions to prevent of falls in community-dwelling elderly people
Appropriate exercise program after evaluation of the multifactorial fall risk assessment
Withdrawal or minimization of psychoactive medications (e.g., sedative hypnotics, anxiolytics, antidepressants) and antipsychotics
Reduced visual acuity due to either cataracts, macular degeneration, glaucoma are very common in elderly and increases risk of falling, should be treated orderly
Treatment of postural hypotension
Treatment of cardiac problems especially arrhythmias
Exercise, in the form of strength training and balance, gait, and coordination training, is effective in reducing falls
Selective use of orthotics could help reduce discomfort, prevent falls and fractures, and improve quality of life
Management of foot problems and footwear - Encourage patient to wear low-heeled shoes
Adaptation or modification of home environment - Rugs should be anchored to prevent slipping - Minimize clutter - Remove loose wires - Use of nonslippery door mats - Install handrails in bathrooms, halls, and long stairways - Light entrances, hallways, halls, stairways