Over 90% of hip and wrist fractures are thought to be the result of a fall.¹¹ A fall of just a few feet may cause a fracture in a person with low BMD. The value of assessing the risk of falling, and intervening in those at high risk (e.g., those with pre-existing fragility fractures), is supported by randomized clinical trials in elderly patients.¹² In those with a pre-existing fragility fracture, fall prevention measures are useful.

Elderly patients may be at risk for falling for a variety of reasons, including frailty and associated deconditioning, poor visual acuity, impaired hearing, and use of medications with neurologic effects that compromise protective neuromuscular reflexes (e.g., long-acting benzodiazepines).¹³ Patients with kyphosis significantly altering posture and gait may also increase the risk of falling.