Fall risk assessment - a comparative analysis of fall risks in elderly and their underlying causes

Falls are a prevalent issue in the geriatric population and can result in dangerous injuries. Every third person above the age of 65 and every second person above the age of 80 experiences at least one fall per year. For elderly, falls often cause serious injuries, such as hip fractures or head injuries entailing tedious healing processes, or even death. After experiencing a fall, 25% of the affected persons have an increased need for care. Though there are many approaches for fall detection, these technologies trigger an alarm only after the fall has occurred. Therefore, we are aiming at preventing the person from falling in the first place to avoid the consequences of such events. Hence, we analyzed risk factors and underlying causes for falls to enable an automatic real-time fall risk assessment of elderly. We classified internal causes for falls in elderly into musculoskeletal deficits, cardiovascular diseases, sensory functions and cognitive and mental impairments, and outlined the correlation between the causes, symptoms and fall risk. Most state-of-the-art methods for automatic fall risk assessment analyze gait characteristics as a general symptom for an increased risk. Many approaches employ accelerometers for observing gait and related movements, while other methods use 3D-cameras or insole pressure sensors. Although many risk factors can be reflected in an abnormal gait, it mainly captures musculoskeletal and cognitive deficits. Furthermore, gait analysis does not provide insight into the underlying causes of an increased fall risk, which would allow for corresponding prevention measures. To improve fall prediction for elderly and enable preventive actions according to the underlying causes, it should also be paid attention to other risk factors. Further investigation will focus on the detection of dizziness and its causes as second general risk factor with a prevalence of 30% in the population above the age of 60.