National Falls Guidelines refreshed after more than 15 years

The Australian Commission on Safety and Quality in Health Care (the Commission) has released the first revision of their Falls Guidelines since 2009.

The Best Practice Guidelines for Prevention Falls and Harm from Falls in Older People provides strategies for the prevention of falls and fall-related injuries across three key settings – hospitals, residential aged care services and community care – and the following factors:

• balance and mobility
• cognitive impairment
• medicines,
• continence
• feet and footwear
• syncope, dizziness and vertigo
• vision
• hearing
• environment
• monitoring and observation
• restrictive practices
• hip protectors
• Vitamin D and calcium
• osteoporosis.

According to the Australian Institute of Health and Welfare, falls were the leading cause of injury hospitalisations in 2023–24 and the leading cause of injury deaths in 2022–23, which also costs the public health system billions of dollars each year.

A person’s balance typically begins to decline at around 45 years-old, with data showing a significant jump in the occurrence of fall injuries after 65.

Australians over 65 years of age are almost 12 times more likely to get injured due to a fall when compared to 25 to 44 year-olds, with people above 85 the most likely to spend time in hospital.

The most common type of fall that results in hospitalisation is a simple slip or trip at home.

The Commission worked with Neuroscience Research Australia (NeuRA) and the Australia and New Zealand Falls Prevention Society (ANZFPS) for five years to deliver the updated guidelines.

Senior research scientist at NeuRA’s Falls, Balance and Injury Research Centre associate professor Jasmine Menant said the consequences of falls can be life-changing for individuals.

“They also have a big impact on our economy, with falls of Australians aged over 65 years old costing the health system more than $2.8 billion annually,” she said. 

The renewed Falls Guidelines combined research and community consultation in the development of recommendations and best practice advice.

“The guidelines build on our work at the Falls, Balance and Injury Research Centre, by translating the highest level of scientific evidence into effective fall prevention initiatives into evidence-based guideline care,” Professor Menant said.

“They recommend a tailored approach with different interventions for different people, according to whether they have fallen in the recent past and what additional individual risk factors they have.”

The guidelines recommend multifactorial interventions as part of routine care for all older people, including regular risk assessments of the individual and their environment, medication reviews and tailored fall prevention plans, alongside increased workforce education and training.

“For example, in residential aged care, there is stronger evidence to support the ongoing delivery of exercise for fall prevention, and in the community, highlighting different approaches to intervention for people with different levels of risk,” Professor Menant said.