[Equilibrium and falls in the elderly].

Falls are the leading cause of injury-related visits to the emergency departments and the primary etiology of accidental deaths in persons over the age of 65 years. The mortality rate for falls increases dramatically with age in both sexes and in all racial ethnic groups, with falls accounting for 70% of accidental deaths in persons 75 years of age and older. Falls can be markers of poor health and declining function, and they are often associated with significant morbidity. Risk factors for falls in the elderly include increasing age, medication use, cognitive impairment and sensory deficits. The evaluation of a patient who has fallen includes a focused history, a direct physical examination and simple tests of postural control and overall physical function. The physician should also evaluate potential obstacles in the living environment of his patients. A progressive program of balance and gait training and muscle strengthening seems to induce compensation for sensory deficit. Healthcare activity should also address psychosocial issues such as the fear of falling and self-imposed restriction of activity. These measurements can reduce the fear of falling and the number of falls altogether. We should encourage measures to promote autonomy and independence in older people.