Our study suggests that falls are a marker of underlying disorders easily identifiable by a careful postfall assessment, which in turn can reduce disability and costs.

D r Rubenstein Falls and gait instability are among the most serious problems facing the aging populationa major cause of mortality, morbidity, immobility, and premature nursing home placement. Many etiologies and risk factors predispose to falls, each requiring an individualized diagnostic and therapeutic approach to minimize likelihood of fall recurrence. In this discussion, two elderly individuals with complex, but fairly typical, fall problems are presented. These are followed by discussions of the epidemiology and common etiologies of falls, recommended diagnostic evaluations for patients following a fall, and more detailed discussion of three of the most important and least well-studied causes of falls: gait instability, muscle weakness, and environmental hazards. CASE PRESENTATIONS Ms SchulmanThe first case is a 95-year-old female board-and-care resident with diagnoses of organic heart disease, hypertension, osteoarthritis, macular degeneration, peripheral vascular disease and a frozen left shoulder. Her fall occurred while bending to pick up an object on the floor. She states only that she "lost her balance" while changing position. She denied dizziness, loss of consciousness or other specific symptoms. No

Integration-measured by the types of exchanges within as opposed to across networks-differentiated the four networks studied. This research contributes to our understanding of the use of multiple measures to evaluate the inner workings of service delivery and their impact on elder health and elder health care.

No abstract