Falls and Fall Prevention in the Elderly: Insights from Jamaica
Falls among the elderly is increasingly being recognized as an issue of concern in both developed and developing countries. Falls in the elderly may precipitate adverse physical, medical, psychological, social and economic consequences. In Jamaica, there are no exhaustive studies or literature that have fully captured the epidemiology, aetiology or impact of such falls, though there is evidence to suggest that it is an issue that warrants some attention. This paper, through the use of quantitative and qualitative methods sought to gain insights on the situation regarding falls among the elderly in Jamaica. Through literature reviews, canvassing of medicals records, conducting focus groups and interviews, perspectives were gleaned on falls among elderly persons in Jamaica. Contributory and risk factors, and perceptions and costs were explored, as were any existing fall prevention policies or policy thrusts. The emerging picture is that falls are not a rare occurrence among older persons in Jamaica and extrinsic factors such as poor road surfaces, poorly constructed steps and poor design of public transportation vehicles etc. are factors that cause falls in the local setting. Similarly, intrinsic factors related to co-morbid condition such as hypertension, diabetes and sensory impairment appear to also contribute to increased risk of falling. Further research on the issue is needed in Jamaica. So too are specific fall prevention policies and programs and actions to address prevailing concerns. Increased awareness of the occurrence of falls among the elderly and mobilization of efforts to decrease such events is needed, complemented by culturally relevant health education and promotion activities. Synergistic efforts of government, civil society, seniors and communities and households will be required for successful fall prevention. The time for planning and action is now.
Falls and Fall Prevention in the Elderly: Insights from Jamaica Introduction A fall can be defined as “unintentionally coming to rest on the ground or other lower level with or without loss of consciousness”.  Falls among the elderly remain an everincreasing problem. Age-related changes and disease both have an impact on an older person’s ability to balance. Similarly, cognitive impairment, various medications, and changes in a person’s environment all appear to contribute to increased risk of falling.  Falls in the elderly are a public health and community problem with adverse physical, medical, psychological, social and economic consequences. These include disability and deformity, fear of repeated falls, curtailment of routine social activities, direct costs of medical care associated with injuries and loss of potential income.
Current literature suggests that the problem is of concern in both the developed and the developing world. In Australia it is estimated that about a third of the elderly living in the community experience at least one fall annually.  Gillespie citing studies from the USA corroboratively asserts that that more than 30% of people aged 65 or older living in the community fall each year, and that the risk of falling increases with age.  Statistics from Ontario, Canada indicate that one-third to one-half of persons over 65 are prone to falling, with falls being more common in older females. 
From the developing world, data are now emerging that suggest falls among the elderly is a growing problem and of significant public health concern. Falls in the elderly in China has been described as a very common complication in social life.  Based on a prospective cohort study in Hong Kong among older adults, the prevalence and incidence of falls were determined to be 19.3% per year and 270 per 1000 person-years respectively; with recurrent falls happening in 4.75% of Chinese older adults every year.  In Africa, one population-based...
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