<unk>  are often caused by a number of factors. The<unk> r may live with many risk factors for<unk> ng and only have problems when another factor appears. As such, management is often tailored to treating the factor that caused the<unk>  rather than all of the risk factors a patient has for<unk> ng. Risk factors may be grouped into intrinsic factors, such as existence of a specific ailment or disease. External or extrinsic factors include the environment and the way in which it may encourage or deter accidental<unk> . Such factors as lighting and illumination, personal aid equipment and floor traction are all important in<unk> prevention. Intrinsic factors *Balance and gait *As a result of stroke disease, Parkinsonism, arthritic changes, neuropathy, neuromuscular disease or vestibular disease. *Visual motor reaction time problems *An extended reaction time will delay responses and compensations to standing or walking imbalances, thus increasing the likelihood of<unk> . *Medications *Polypharmacy is common in<unk>  people *Sedatives significantly increase the risk of<unk> ng *Cardiovascular medications can contribute towards<unk>  *Visual impairment *Visual impairments, glaucoma, macular degeneration and retinopathy increase the risk of<unk> ng and of hip fractures. *Bifocals and trifocals can increase the risk of<unk> ng as the lower portion of corrective lenses are optimized for distances approximately 18inches, thus precluding clear vision of one's feet/floor, approximately 4.5 to 5.5 feet below one's eyes. *Cognitive problems *Dementia increases the likelihood of<unk>  *Cardiovascular causes *Orthostatic hypotension *Postprandial hypotension *Carotid sinus syndrome *Neurocardiogenic syncope– the commonest cause of syncope in A&E patients *Cardiac arrhythmias *Structural heart disease, such as valvular heart disease Extrinsic factors Hanging straps with triangular handles in a modern Japanese commuter train commuter train catering for mainly seated passengers A staircase with metal handrails *Poor lighting due to low luminance of existing lights or lamps, so preventing hazard identification and avoidance. Eyesight deteriorates with age, and extra lighting will be needed where seniors move frequently. The power of the bulbs used should be higher than normally accepted, with incandescent bulbs preferred or LEDs? especially as they react much more quickly than other types of bulb when switched on. This is vital when entering a room where an obstacle can trip the user for example, especially if not seen in time to prevent the accident. *Stairs with inadequate handrails, or too steep, encouraging trips and<unk> . The steps should be spaced widely with low risers, and surfaces should be slip-resistant. Softer surfaces can help limit impact injuries by cushioning loads. *Doorways with adequate headroom so that the user's head does not hit the lintel. Doorways of low headroom (less than about 2 metres) are common in old houses and cottages for example. *Rugs/floor surfaces with low friction, causing poor traction and individual instability. All surfaces should have a high friction coefficient with shoe soles. *Clothing/footwear poorly fitted, shoes of low friction against floor. Rubber soles with ribs normally have a high friction coefficient, so are preferred for most purposes. Clothing should fit the user well, without trailing parts (hems<unk> ng below the heel and loose shoe strings) which could snag with obstacles *Lack of equipment/aids such as walking sticks or walking frames, such as Zimmer frames so as to improve user stability. Grab bars and hanging straps should be supplied plentifully, especially in critical areas where users may be vulnerable.
Falls in older adults
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Old age and driving
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