Human balance is thought to depend on the interaction of multiple sensory, motor and integrative systems. There is a growing body of evidence that indicates that functioning in sensory, motor and integration systems decline significantly with age and that impairment in these systems is associated with falling in elderly persons.
In fact, in many sensorimotor systems, researchers have noted that even in the absence of any documented pathology, many people experience age-related declines in function. We have also found that on clinical examination, many older persons with a history of falls have no identifiable neurological or musculoskeletal pathology yet perform poorly in tests of sensori-motor function. Our approach to balance and falls is functional rather than disease-oriented. We focus on physiological systems, with complementary studies to understand additional risk factors, such as footwear-surface interactions, confusion and dementia, eyewear, hospital settings, fear and risk-taking behaviours.
Increased susceptibility to falling is one of the most serious and costly problems associated with ageing. Approximately one third of people aged 65 years and over living in the community fall at least once a year, with between 11% and 17% of these people suffering multiple falls. Falls are the leading cause of injury-related death and hospitalisation in persons aged 65 years and over. It has been estimated that at least 40% of people who have been hospitalised because of a fall are discharged to nursing home care and a further 10% of people need ongoing assistance at home from community services. The rate of falling in institutionalised older people is even higher with various studies reporting fall rates of between 40% and 56% in elderly residents each year. Multiple factors play a role in fall causation and injury; however balance impairments contribute to the majority of falls in older adults.
Human balance is thought to depend on the interaction of multiple sensory, motor and integrative systems. There is a growing body of evidence that indicates that functioning in sensory, motor and integration systems decline significantly with age and that impairment in these systems is associated with falling in elderly persons. In fact, in many sensorimotor systems, researchers have noted that even in the absence of any documented pathology, many people experience age-related declines in function. We have also found that on clinical examination, many older persons with a history of falls have no identifiable neurological or musculoskeletal pathology yet perform poorly in tests of sensori-motor function. Our approach to balance and falls is functional rather than disease-oriented. We focus on physiological systems, with complementary studies to understand additional risk factors, such as footwear-surface interactions, confusion and dementia, eyewear, hospital settings, fear and risk-taking behaviours.
Our research has made a contribution across the full range of falls research from epidemiology to randomised controlled trials. This work has contributed to the understanding of sensory and motor contributions to balance and many of the diverse factors causing falls, from the physiological to pharmacological, clinical, life style and environmental. We have identified and quantified key factors contributing to falls risk. We have developed and tested a battery of physiological tests, to identify those at risk of falling, which is capable of predicting elderly fallers with an accuracy of 75%. This physiological profile assessment is now used widely both clinically and in fall prevention trials throughout Australia and across the world.