The number of elderly people attending casualty departments following a repeat fall could be drastically cut if more thorough assessments were carried out, a study has found.

Eight per cent of people aged 70 and over are estimated to visit accident and emergency departments each year suffering fall-related injuries.

Of these, 30-40% are admitted to hospital.

More falls occur in the winter owing to weather conditions. Such falls can cause severe physical and psychological damage, leading to loss of independence or even death.

Research published in The Lancet medical journal suggests that the number of repeat falls could be cut by more than 50% under a new system.

The system tries to identify the reason why the patient fell and correct the cause rather than just treating the resultant injury and sending the patient home.

Assessments

The study was carried out by Dr Jacqueline Close and colleagues at the Clinical Age Research Unit at King's College, London.

Repeat falls can result in hospitalisation

They split patients over the age of 65 who attended after a fall into two groups. One was given standard treatment, the other was given an assessment by a geriatrician followed by a home visit.

Dr Close said of the second group: "We focused very much on vision, balance, cognition - whether they were confused or had an element of dementia - and drugs."

She said a usual visit to A&E would consist of being bandaged up and sent home without anyone finding out why the fall occurred in the first place.

At the end of a one-year follow-up period there was a greater than 61% reduction in the number of falls in the assessed group.

Dr Close said there was an added benefit to the process. "Not only were they less likely to fall. They were physically in better shape at the end of that period.

"They were more independent and that normally translates into better quality of life."

Simple solutions

The cost of a fall is also high to the health service.

The assessed group were more likely to maintain independence

Dr Close said that the assessment method led to cost-effective solutions.

She said: "We were picking up people whose vision was impaired and all they had to do was visit the optician.

"We picked up a lot of people who aren't able to get to the opticians in the first place, so we brought the optician into the day hospital."

In other cases a chiropodist was called in or suitable footwear found.

The system has been adopted at King's College Hospital A&E, where patients are referred to a clinic, and Dr Close said she hoped other centres would introduce it.

'Improved wellbeing'

A spokesperson for Age Concern said: "Prevention is always better than cure - better for the patient and more cost effective in the long run.

"As well as causing physical damage, a fall can dent an older person's confidence about going out and so contribute to feelings of loneliness and isolation, especially in the winter when paths may be icy.

"Thorough assessments and treatment of older people who have had a fall will improve their wellbeing and quality of life, as well as their health."