New findings from The Irish Longitudinal Study on Ageing (TILDA) at Trinity College Dublin underline that falls among older people are a serious and expanding challenge for Ireland’s health system. The research shows that while very large numbers of older adults require medical care every year because of falls, the services needed to prevent repeat incidents and manage risk are often unavailable or difficult to access. This mismatch between need and provision is placing growing pressure on hospitals, emergency departments and community services.
The study, titled The DEFINED Study: Determining the burden of falls amongst community-dwelling older people in Ireland to inform falls care delivery, is published today in the international journal BMJ Open. Drawing on nationally representative data, the researchers found that falls are not isolated or rare events but a routine cause of injury and healthcare use among older adults. Each year, one in eight people aged 70 and over in Ireland requires medical attention following a fall, and one in sixteen attends an emergency department as a result. In practical terms, this translates to almost 62,000 older people needing medical care annually because of falls, with more than 32,000 presenting to emergency departments.
Beyond the immediate injury, the consequences of falls are often long-lasting. Falls are the leading cause of fractures in older people and a major factor in reduced mobility, loss of confidence and declining independence. Once a fall has occurred, the likelihood of further falls increases significantly if underlying risk factors are not addressed. Despite this well-established pattern, the research highlights substantial weaknesses in both prevention strategies and follow-up care. Many older adults who experience a fall are treated for the immediate injury but do not receive a comprehensive assessment or intervention to reduce the chance of recurrence.
A particularly concerning finding relates to medication use. More than half of older people who attended an emergency department because of a fall were prescribed medicines known to increase falls risk, including drugs that affect balance, alertness or blood pressure. This suggests that opportunities to review and modify treatment are frequently missed, even in acute care settings where falls risk should be a clear concern. In addition, over one in five older people who required medical attention for a fall reported having no access to a specialist falls assessment clinic, further limiting the possibility of effective prevention.
Ireland’s demographic trends make these findings especially significant. The country has the fastest ageing population in the European Union, and falls are already the most common reason for hospital admission among older people. As the population continues to age, the number of falls and related injuries is expected to rise sharply in the coming decades. Yet evidence consistently shows that most falls can be prevented through relatively straightforward measures, such as structured medication review, cardiovascular assessment, and targeted strength and balance exercise programmes delivered in the community.
Commenting on the findings, lead author Dr Robert Briggs, Consultant Geriatrician at St James’s Hospital and a TILDA investigator, emphasised that falls should not be dismissed as an unavoidable part of ageing. He noted that many older people are presenting repeatedly to emergency departments while taking medications that heighten their risk. Yet, only a minority can access specialist services designed to address the problem. Professor Rose Anne Kenny, Principal Investigator of TILDA, added that although prevention and treatment approaches remain inadequate, ongoing regional reorganisation of health services presents a critical opportunity. A coordinated national strategy focusing on prevention, multidisciplinary care and improved access to falls clinics could significantly reduce avoidable injuries, hospital admissions and loss of independence among older people.
More information: Robert Briggs et al, Determining the burden of falls amongst community-dwelling older people in Ireland to inform falls care delivery: secondary data analysis from the Irish longitudinal study on ageing – the defined study, BMJ Open. DOI: 10.1136/bmjopen-2025-107647
Journal information: BMJ Open Provided by Trinity College Dublin
