International Journal of Clinical Case Reports, 2025, Vol.15, No.5, 200-208 http://medscipublisher.com/index.php/ijccr 201 2 Risk Factors for Falls Among the Elderly 2.1 Physiological factors: balance issues, chronic diseases, and drug use Balance problems are the main physiological risk factors for falls among the elderly in the community. Balance and activity limitations significantly increase the risk of single and repeated falls. A summary of studies shows that balance problems can triple the risk of falls (Jehu et al., 2021; Li et al., 2022). Abnormal gait, muscle weakness and sensory function decline will further increase this risk. Therefore, tests of balance and body function are very important in fall risk assessment (Saunders et al., 2025). Chronic diseases such as diabetes, heart disease, hypertension, stroke and Parkinson's disease are also significantly associated with an increased risk of falls. Frailty is a state of reduced physical reserves and is closely related to a higher incidence of falls. Compared with elderly people of the same age but not frail, frail elderly people have a 48% higher risk of falls (Xu et al., 2022; Yang et al., 2023). In addition, taking multiple medications or certain specific drugs - especially psychotropic drugs, antihypertensive drugs, and drugs that act on the central nervous system - is also often regarded as an important cause of falls, as these drugs may lead to problems such as dizziness, orthostatic hypotension, and decreased attention (Yang et al., 2016). 2.2 Psychological factors: cognitive decline, depression, fear of falling Cognitive decline, especially slower executive ability and processing speed, is an important psychological risk factor for falls. Elderly people with dementia or mild cognitive impairment have a significantly higher risk. Dementia almost doubles the risk of falling (Li et al., 2022). Inattention and weakened judgment can easily lead to unsafe behaviors and reduced risk awareness, thereby further increasing the possibility of falls (Saunders et al., 2025). Depression and the fear of falling are also common psychological factors. Depression can increase the risk of falls by up to 23%, which may be related to reduced activity, poor attention and side effects of medication. Fear of falling is quite common among the elderly. It can cause limited activity, muscle incoordination, thereby increasing the risk of falling and causing further psychological distress (Xu et al., 2022). Therefore, addressing these psychological issues is crucial for comprehensive fall prevention. 2.3 Environmental factors: insufficient family safety and inadequate community facilities Environmental issues are also crucial in the risk of falls among the elderly. Unsafe home environments-such as insufficient light, slippery floors, loose carpets and lack of handrails-are common causes of falls (Mehta et al., 2021; Xu et al., 2022). Since many elderly people spend most of their time at home, it is important to identify and improve these problems as protective measures. Incomplete community supporting facilities, such as uneven roads, dim lighting, and difficulties in entering and exiting public places, all increase the risk of falls among the elderly in the community (Qian et al., 2020). Certain social factors, such as living in areas with poorer economic conditions, or lacking social activities or support, are also associated with a higher incidence of falls. Although the importance of environmental factors has been recognized, studies show that compared with physiological and psychological factors, research on the environment is still relatively scarce. This indicates that a more careful assessment of the environment should be conducted in fall prevention programs (Saunders et al., 2024; Saunders et al., 2025). 3 Overview of Common Fall Risk Assessment Tools 3.1 Common tools A variety of fall risk assessment methods are often used to identify elderly people at risk of falls, especially in community and primary care. The Moors Fall Scale (MFS), Tinetti Balance Assessment (also known as Performance-Oriented Activity Assessment, POMA), and Hendrich II Fall Risk Model are the most common. These tools are popular for their simplicity, ease of use and low equipment requirements, and can be used in places such as clinics and community centers. In addition, there are some common methods, such as Timed Up and Go (TUG) test, Berg Balance Scale (BBS), gait speed and functional range test, which reflect the activities and balance of the elderly from different perspectives (Meekes et al., 2021).
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