In March 1996, Dr Lewis Lipsitz discussed an 85-year-old woman who had fallen several times in the preceding year.1 Mrs R had symptoms of spinal stenosis and peripheral neuropathy. She complained at times of dizziness and vertigo, with neurologic and radiographic evaluation yielding a diagnosis of benign positional vertigo. There was no evidence for cardiac arrhythmia.
Dr Lipsitz discussed the prevalence and etiology of falls in the elderly. He contrasted factors related to age with those related to disease. He described a strategy for the orderly evaluation of elderly patients with falls or near-falls, and outlined treatment and preventive techniques shown useful in managing the complex issues these patients and their physicians face.
In the year following the conference, Mrs R underwent physical therapy, focusing on improving both balance and strength. Subsequently, she fell once, for no clear reason, and was unhurt. A month before this report, she fell