Conditions/factors that may cause a tendency to fall:
Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99).
- Hydrocephalus (hydrocephalus; abnormal enlargement of the fluid-filled fluid spaces (cerebral ventricles) of the brain).
Eyes and eye appendages (H00-H59).
- Visual acuity reduction (visual impairment).
Blood, blood-forming organs – immune system (D50-D90).
- Anemia (anemia)
Endocrine, nutritional, and metabolic diseases (E00-E90).
- Hyponatremia (sodium deficiency) – 10-fold increased risk of falls in “asymptomatic “chronic hyponatremia compared with normonatremia.
- Hypothyroidism (underactive thyroid gland).
Cardiovascular system (I00-I99)
- Aortic stenosis – obstruction (narrowing) of the outflow tract of the left ventricle.
- Apoplexy (stroke), post-stroke.
- Blood pressure fluctuations (esp. hypotension/low blood pressure).
- Circulatory disorders of the central nervous system.
- Cardiac arrhythmias – both bradycardic (slow) and tachycardic (fast) disorders (e.g., ventricular tachycardia!).
- Brainstem ischemia – reduced blood flow in the vessels supplying the brainstem.
- Silent myocardial infarction (heart attack).
Infectious and parasitic diseases (A00-B99).
- Infections, unspecified
Musculoskeletal system and connective tissue (M00-M99).
- Osteoarthritis
- Restricted mobility, unspecified
- Rheumatoid arthritis
- Sarcopenia (muscle weakness or muscle wasting).
Ears – mastoid process (H60-H95)
- Balance disorders
- Hearing disorders (synonyms: disacusis; dysacusis; hypacusis; hypoacusis; surditas; deafness).
- Disorders of vestibular function (vertigo, e.g., labyrinthitis, Meniere’s disease).
Psyche – Nervous System (F00-F99; G00-G99).
- Acute alcohol intoxication and chronic alcohol abuse (alcohol dependence).
- Dementia (deficit in cognitive, emotional, and social skills; e.g., Alzheimer’s dementia)
- Depression
- Diabetic autonomic neuropathy – diabetes-related nervous disease of autonomic nerves.
- Epilepsy
- Gait disorders
- Hydrocephalus (hydrocephalus; pathological enlargement of the liquid-filled fluid spaces (cerebral ventricles) of the brain).
- Cognitive impairment (human functions related to perception, learning, remembering, and thinking, i.e., human cognition and information processing), not specified
- Concentration disorders
- Parkinson’s disease (shaking palsy)
- Multiple sclerosis (MS)
- Neurological disorders, unspecified
- Paresis (paralysis), unspecified
- Peripheral neuropathy (disruption of one or more peripheral nerves) – including chemotherapy-induced peripheral neuropathy.
- Polyneuropathy – degenerative disease of the peripheral nerves.
- Spinal cord damage, unspecified
- Cystic changes in the cerebral ventricles resulting in sudden and short-lived drop attacks (“fall attack”; sudden fall event with unaffected consciousness due to loss of tone in the lower extremities)
Symptoms and abnormal clinical and laboratory findings not classified elsewhere (R00-R99)
- Asterixis (“flapping wings,” flutter tremor).
- Chronic pain – in adults over 50 years of age and presence of multilocular (“in multiple locations”) pain, the tendency to fall is almost doubled compared to peers without pain
- Gait disorder, unspecified
- Urinary incontinence (bladder weakness)
- Syncope – short-lasting fainting due to an undersupply of oxygen to the brain.
- Vertigo (dizziness; e.g., labyrinthitis, Meniere’s disease).
Further
- Physiological changes in old age*
Medication
- Medication side effects
- Alpha blockers-significantly more men fell after starting therapy than men in the control group (1.45 versus 1.28%). Relatively, the difference was about 12%; absolutely, it was only 0.17%; bone fractures were recorded in 0.48% of patients on alpha blockers and in 0.41% without (the difference was significant)
- Benzodiazepines, phenothiazines, tricyclic antidepressants; antihypertensives – people who had already had a fall[1] were particularly at risk); another study was unable to confirm the association with antihypertensives: in fact, it was able to demonstrate a significantly low risk of falls resulting in injury for ACE inhibitors and calcium antagonists; another study was also able to demonstrate a lower risk of falls for RAAS inhibitors
- Polypharmacy (> 6 prescribed medications).
- Other drugs see below delirium
* Physiological changes in old age include:
- General weakness
- Orthostatic hypotension – drop in blood pressure associated with standing up.
- Alteration of attention, coordination and speed
- Decreased proprioception (perception of depth sensitivity and body position in space).
- Decreased vision
- Increasing postural instability
