Prevention of fall injuries among senior citizens in the European Union

In one or two decades, most countries in the West will count more than 20% of its population as being over 65 years. Although not all people in the third age are frail, statistics show that injury risks increase significantly with older age. Injury therefore presents a real threat to the health and well-being of senior citizens in our society. It results not only in premature death but in particular in a massive reduction in quality of life due to consequent disabilities and handicaps. Falls are the major injury type and, on top of a significant increase in risk population in absolute numbers, we also see an increase in incidence rates in standardized populations as regards hospitalizations due to fall injuries. A multitude of risk factors is involved in fall events and resulting injuries and these factors therefore need careful analysis before deciding on prevention strategies. These factors include a decrease in functional capacities such as eye sight and hearing, decreasing mobility, (multi-)medication, and hazards in the domestic environment. All these factors should be considered with an eye toward prevention, especially those factors that are open to change and intervention, such as environmental factors, prescription of medicines and general physical condition. But since the population of 55 years and older is not at all homogeneous, prevention programs have to be well-targeted and well-focused at specific risk groups and opportunities for intervention. In that perspective, at least two different risk groups are distinguished in this paper: in the first place, senior citizens living independently at home and still living an active life, and secondly senior citizens admitted to nursing homes or care facilities, who are frail and most vulnerable. The paper highlights the ingredients of successful interventions that are targeted at both groups and advocates concerted actions at the national and local level, forging partnerships among the relevant professions and interest groups, including senior citizens themselves and their unions. An important role is also foreseen for the European Commission in providing support for exchanging research findings and intervention practice. It is suggested that a European network for Injury Prevention and Safety Promotion, with due regard for senior citizens, be established within the framework of the proposed Public Health program.