Who may be at higher risk of falling

Older age increases falls risk, but age alone is not the only factor. NICE covers people aged 65 and over and those aged 50 to 64 who are at higher risk. In care settings, frailty, long-term conditions, recent illness, previous falls, cognitive impairment and reduced mobility make some people more likely to fall.

Anyone who has fallen, or who has had repeated near misses, needs prompt attention. A recent loss of balance or confidence can signal a change in health or function.

Examples of people who may need extra attention

• People with a recent fall or recurrent falls: a single fall should prompt concern; repeated falls require a full review.
• People living with frailty: weakness, slowed movement, fatigue and poorer recovery from illness increase risk.
• People with long-term conditions that affect daily life: for example arthritis, dementia, diabetes, Parkinson's disease or the effects of stroke.
• People with new confusion or delirium: especially after infection, dehydration, hospital discharge or changes to medicines.
• People with urinary urgency or nocturia: rushing to the toilet, particularly at night, commonly triggers falls.
• People with poor vision, poor hearing or unsafe footwear: missing glasses or hearing aids, and painful feet, make usual routes hazardous.
• People using walking aids: frames, sticks and wheelchairs reduce risk only if they are available and used as planned.

Manager focus: residential care review

Higher risk does not mean inevitable falling. It means staff should notice changing patterns early and act to prevent harm.