Abstract
Introduction: Falls in older people are a major public health concern causing much morbidity, mortality and cost to health and social services. Frailty and co-morbidities are important risk factors for falls and a multidisciplinary approach and geriatric services are best suited to manage older fallers. Falls clinics led by geriatricians have been developed over the last three decades. However, as there is much variation in availability of geriatric services across Europe it is unclear to what extent Falls clinics/services exist across the continent. This study aimed to assess the prevalence of geriatrician-led Falls clinics/services across Europe.
Methods: A cross-sectional survey of the European Union of Medical Specialists-Geriatric Medicine Section was performed. Falls clinics/services were one of twenty-five types of geriatric services assessed. The questionnaire classified services into four levels: No-0(not available), Yes-1(Minority of institutions;<25%), Yes-2(Some;25%-75%) or Yes-3(Majority;>75%). A descriptive comparative analysis was performed.
Results: Responses were obtained from 39 countries, which were categorized into four European geographic groups: Nordic(n=5), Central-West(n=9), Eastern(n=17) and Southern(n=8). Overall 41.0%(6/39) of countries had some degree of falls services. All Nordic countries and most(88.9%;8/9) Central-West had at least some falls services, compared to only 37.5%(3/8) and none in Southern and Eastern countries respectively. Only four countries (Denmark, Ireland, Malta and United Kingdom) had Falls services in the majority of their institutions.
Conclusions: There is much variation across Europe in the presence of Falls clinics/services, which are commoner in Nordic/Central-West countries, less common in Southern countries and non-existent in Eastern countries. In part this is likely to be due to lack of recognition of geriatric medicine as a specialty in some countries. The World Falls Guidelines (Montero-Odasso et al,2022) advocate a multidisciplinary multifactorial approach to falls assessment and management in older people. These data should help policymakers to develop Falls service for older people across the continent.
Comments
Are there any alternatives? Do GPs conduct these assessments?
Quite an interesting study, thanks! Do we have any information on whether these falls assessments happen at all? Do GPs normally conduct them in such settings or are they not conducted at all?
Thanks for your question -…
Thanks for your question - This is a limitation - we did not collect information on whether these happen in primary care, this would be interesting to know!