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MedGen UID:
Concept ID:
Synonym: Fall
SNOMED CT: Falls (161898004); Fall (1912002)
HPO: HP:0002527


A sudden movement downward, usually resulting in injury. [from NCI]

Conditions with this feature

Supranuclear palsy, progressive, 2
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Disease or Syndrome
Myosin storage myopathy
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Disease or Syndrome
Autosomal dominant myosin storage congenital myopathy-7A (CMYP7A) is a skeletal muscle disorder with wide phenotypic variability. The age at symptom onset can range from early childhood to late adulthood. Affected individuals have proximal muscle weakness affecting the upper and lower limbs and distal muscle weakness of the lower limbs, resulting in gait difficulties and scapular winging (scapuloperoneal myopathy). Additional features may include thin habitus, high-arched palate, foot drop, pes cavus, calf pseudohypertrophy, and decreased reflexes. The severity is also variable: some patients develop respiratory insufficiency, joint contractures, and scoliosis in the first decades, whereas others are clinically unaffected, but show subtle signs of the disorder on examination. Serum creatine kinase may be normal or elevated. The disease is usually slowly progressive and most patients remain ambulatory. Skeletal muscle biopsy can show different abnormalities, including hyaline bodies, type 1 fiber predominance, congenital fiber-type disproportion (CFTD), and nonspecific myopathic changes with myofibrillar disarray. Intrafamilial variability is common (Dye et al., 2006; Pegoraro et al., 2007; review by Tajsharghi and Oldfors, 2013). For a discussion of genetic heterogeneity of congenital myopathy, see CMYP1A (117000).
Syndromic X-linked intellectual disability Hedera type
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Disease or Syndrome
The Hedera type of X-linked syndromic intellectual developmental disorder (MRXSH) is characterized by global developmental delay apparent from infancy and progressive neurologic decline with abnormal movements, spasticity, and seizures. Brain imaging shows volume loss of cortical white and gray matter, thin corpus callosum, and myelination defects, consistent with a neurodegenerative process. Only males are affected (summary by Hirose et al., 2019).
Charlevoix-Saguenay spastic ataxia
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Disease or Syndrome
Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is clinically characterized by a progressive cerebellar ataxia, peripheral neuropathy, and spasticity. Disease onset of classic ARSACS is often in early childhood, leading to delayed walking because of gait unsteadiness in very young toddlers, while an increasing number of individuals with disease onset in teenage or early-adult years are now being described. Typically the ataxia is followed by lower-limb spasticity and later by peripheral neuropathy – although pronounced peripheral neuropathy has been observed as a first sign of ARSACS. Oculomotor disturbances, dysarthria, and upper-limb ataxia develop with slower progression than the other findings. Brain imaging demonstrates atrophy of the superior vermis and the cerebellar hemisphere with additional findings on MRI, such as linear hypointensities in the pons and hyperintense rims around the thalami. Many affected individuals (though not all) have yellow streaks of hypermyelinated fibers radiating from the edges of the optic disc noted on ophthalmologic exam, and thickened retinal fibers can be demonstrated by optical coherence tomography. Mild intellectual disability, hearing loss, and urinary urgency and incontinence have been reported in some individuals.
Leber congenital amaurosis 14
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Disease or Syndrome
Autosomal recessive childhood-onset severe retinal dystrophy is a heterogeneous group of disorders affecting rod and cone photoreceptors simultaneously. The most severe cases are termed Leber congenital amaurosis, whereas the less aggressive forms are usually considered juvenile retinitis pigmentosa (Gu et al., 1997). For a general phenotypic description and a discussion of genetic heterogeneity of Leber congenital amaurosis, see LCA1 (204000); for retinitis pigmentosa, see 268000.
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Disease or Syndrome
Oxoglutarate dehydrogenase deficiency (OGDHD) is an autosomal recessive disorder associated with features of infantile- and pediatric-onset basal ganglia-associated movement disorders, hypotonia, developmental delays, ataxia, and seizures (summary by Yap et al., 2021).
Mitochondrial DNA deletion syndrome with progressive myopathy
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PEOA6 is characterized by muscle weakness, mainly affecting the lower limbs, external ophthalmoplegia, exercise intolerance, and mitochondrial DNA (mtDNA) deletions on muscle biopsy. Symptoms may appear in childhood or adulthood and show slow progression (summary by Ronchi et al., 2013). For a general phenotypic description and a discussion of genetic heterogeneity of autosomal dominant progressive external ophthalmoplegia, see PEOA1 (157640).
Myopathy, tubular aggregate, 2
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Disease or Syndrome
Any tubular aggregate myopathy in which the cause of the disease is a mutation in the ORAI1 gene.
Congenital myasthenic syndrome 11
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Disease or Syndrome
Congenital myasthenic syndrome associated with AChR deficiency is a disorder of the postsynaptic neuromuscular junction (NMJ) clinically characterized by early-onset muscle weakness with variable severity. Electrophysiologic studies show low amplitude of the miniature endplate potential (MEPP) and current (MEPC) resulting from deficiency of AChR at the endplate. Treatment with cholinesterase inhibitors or amifampridine may be helpful (summary by Engel et al., 2015). For a discussion of genetic heterogeneity of CMS, see CMS1A (601462).
Supranuclear palsy, progressive, 1
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Disease or Syndrome
The spectrum of clinical manifestations of MAPT-related frontotemporal dementia (MAPT-FTD) has expanded from its original description of frontotemporal dementia and parkinsonian manifestations to include changes in behavior, motor function, memory, and/or language. A recent retrospective study suggested that the majority of affected individuals have either behavioral changes consistent with a diagnosis of behavioral variant FTD (bvFTD) or, less commonly, a parkinsonian syndrome (i.e., progressive supranuclear palsy, corticobasal syndrome, or Parkinson disease). Fewer than 5% of people with MAPT-FTD have primary progressive aphasia or Alzheimer disease. Clinical presentation may differ between and within families with the same MAPT variant. MAPT-FTD is a progressive disorder that commonly ends with a relatively global dementia in which some affected individuals become mute. Progression of motor impairment in affected individuals results in some becoming chairbound and others bedbound. Mean disease duration is 9.3 (SD: 6.4) years but is individually variable and can be more than 30 years in some instances.
Charcot-Marie-Tooth disease, dominant intermediate G
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Disease or Syndrome
CMTDIG is an autosomal dominant neurologic disorder with a highly variable phenotype. Most affected individuals have onset in the first or second decades of slowly progressive distal motor weakness and atrophy, resulting in gait instability and distal upper limb impairment, as well as distal sensory impairment. More severely affected individuals may have pes cavus and claw hands and become wheelchair-bound, whereas other affected individuals have later onset with a milder disease course. Electrophysiologic studies tend to show median motor nerve conduction velocities (NCV) in the 'intermediate' range, between 25 and 45 m/s (summary by Berciano et al., 2017). In a review of intermediate CMT, Berciano et al. (2017) noted that advanced axonal degeneration may induce secondary demyelinating changes resulting in decreased NCV and attenuated compound muscle action potential (CMAP) in median nerve conduction studies. They thus suggested that testing the upper arm, axilla to elbow, may provide more accurate assessment of NCV and CMAP and reveal an intermediate phenotype (review by Berciano et al., 2017). For a discussion of genetic heterogeneity of CMTDI, see 606482.
Intellectual disability, autosomal dominant 58
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Disease or Syndrome
Mitochondrial complex 1 deficiency, nuclear type 2
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Disease or Syndrome
Progressive myoclonic epilepsy type 8
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Disease or Syndrome
Progressive myoclonic epilepsy-8 (EPM8) is a rare autosomal recessive form of progressive myoclonic epilepsy with phenotypic variability including ataxia and other movement disorders in addition to myoclonus (summary by Godeiro et al., 2018). For a discussion of genetic heterogeneity of progressive myoclonic epilepsy, see EPM1A (254800).
Mitochondrial DNA depletion syndrome 18
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Disease or Syndrome
Mitochondrial DNA depletion syndrome-18 (MTDPS18) is an autosomal recessive neuromuscular disorder characterized by early-onset progressive weakness and atrophy of the distal limb muscles, resulting in loss of ambulation as well as atrophy of the intrinsic hand muscles with clawed hands. Affected individuals may also develop scoliosis and have hypo- or hyperreflexia and decreased pulmonary vital capacity. Examination of skeletal muscle shows neurogenic atrophy and combined mitochondrial oxidative phosphorylation deficiency associated with mtDNA depletion. The clinical phenotype is reminiscent of spinal muscular atrophy (see SMA, 253300) and the metabolic profile is reminiscent of 2-aminoadipic 2-oxoadipic aciduria (AMOXAD; 204750), which is caused by mutation in the DHTKD1 gene (614984) (summary by Boczonadi et al., 2018). For a discussion of genetic heterogeneity of autosomal recessive mtDNA depletion syndromes, see MTDPS1 (603041).
Muscular dystrophy, limb-girdle, autosomal recessive 26
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Disease or Syndrome
Autosomal recessive limb-girdle muscular dystrophy-26 (LGMDR26) is a muscle disorder characterized by adult-onset weakness primarily affecting the proximal muscles of the lower limbs. The disorder is slowly progressive, with later involvement of the upper limbs and fatty replacement of muscle tissue apparent on MRI. Some patients may have calf hypertrophy. Serum creatine kinase is significantly elevated, and skeletal muscle biopsy shows typical dystrophic features with normal ultrastructural findings. There is no cardiac or respiratory involvement (summary by Vissing et al., 2019). For a discussion of genetic heterogeneity of autosomal recessive limb- girdle muscular dystrophy, see LGMDR1 (253600).
Retinal dystrophy with leukodystrophy
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Disease or Syndrome
Retinal dystrophy and leukodystrophy (RDLKD) is a peroxisomal enzyme deficiency caused by impaired very long chain fatty acid (VLCFA) metabolism. Patients exhibit ataxia and spastic paraparesis as well as developmental delay, and may show facial dysmorphism (Ferdinandusse et al., 2017).
Intellectual developmental disorder with paroxysmal dyskinesia or seizures
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Disease or Syndrome
Intellectual developmental disorder with paroxysmal dyskinesia or seizures (IDDPADS) is an autosomal recessive complex neurologic disorder characterized by global developmental delay with impaired intellectual development and language delay. In addition, most patients develop a paroxysmal hyperkinetic movement disorder in the first months or years of life manifest as sudden falls or backward propulsion, eye or head deviation, and dystonic limb posturing followed by chorea and dyskinetic movements. The episodes are pharmacoresistant to anticonvulsant medication. EEG may show interictal abnormalities, but are usually not consistent with epilepsy. However, some patients may also develop epileptic seizures or only have seizures without a movement disorder (summary by Doummar et al., 2020).
Mitochondrial complex 2 deficiency, nuclear type 4
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Concept ID:
Disease or Syndrome
Mitochondrial complex II deficiency nuclear type 4 (MC2DN4) is a severe autosomal recessive disorder characterized by early-onset progressive neurodegeneration with leukoencephalopathy. Acute episodes of neurodegeneration are often triggered by catabolic stress such as infection or fasting.
Developmental delay, impaired speech, and behavioral abnormalities
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Disease or Syndrome
Developmental delay, impaired speech, and behavioral abnormalities (DDISBA) is characterized by global developmental delay apparent from early childhood. Intellectual disability can range from mild to severe. Additional variable features may include dysmorphic facial features, seizures, hypotonia, motor abnormalities such as Tourette syndrome or dystonia, and hearing loss (summary by Cousin et al., 2021).
Neurodevelopmental disorder with hypotonia and dysmorphic facies
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Disease or Syndrome
Neurodevelopmental disorder with hypotonia and dysmorphic facies (NEDHYDF) is characterized by global developmental delay and hypotonia apparent from birth. Affected individuals have variably impaired intellectual development, often with speech delay and delayed walking. Seizures are generally not observed, although some patients may have single seizures or late-onset epilepsy. Most patients have prominent dysmorphic facial features. Additional features may include congenital cardiac defects (without arrhythmia), nonspecific renal anomalies, joint contractures or joint hyperextensibility, dry skin, and cryptorchidism. There is significant phenotypic variability in both the neurologic and extraneurologic manifestations (summary by Tan et al., 2022).
Autosomal recessive spastic paraplegia type 78
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Concept ID:
Disease or Syndrome
Autosomal recessive spastic paraplegia-78 is an adult-onset neurodegenerative disorder characterized predominantly by spasticity and muscle weakness of the lower limbs, resulting in gait difficulties and loss of ambulation in some patients. Affected individuals also have cerebellar signs, such as dysarthria, oculomotor disturbances, and limb and gait ataxia; brain imaging shows cerebellar atrophy. Some patients may have mild cognitive impairment or frank dementia. The phenotype is highly variable (summary by Estrada-Cuzcano et al., 2017). Biallelic mutation in the ATP13A2 gene also causes Kufor-Rakeb syndrome (KRS; 606693), a neurodegenerative disorder with overlapping features. Patients with KRS have earlier onset and prominent parkinsonism. Loss of ATP13A2 function results in a multidimensional spectrum of neurologic features reflecting various regions of the brain and nervous system, including cortical, pyramidal, extrapyramidal, brainstem, cerebellar, and peripheral (summary by Estrada-Cuzcano et al., 2017).

Professional guidelines


Wieling W, Kaufmann H, Claydon VE, van Wijnen VK, Harms MPM, Juraschek SP, Thijs RD
Lancet Neurol 2022 Aug;21(8):735-746. doi: 10.1016/S1474-4422(22)00169-7. PMID: 35841911Free PMC Article
Montero-Odasso MM, Kamkar N, Pieruccini-Faria F, Osman A, Sarquis-Adamson Y, Close J, Hogan DB, Hunter SW, Kenny RA, Lipsitz LA, Lord SR, Madden KM, Petrovic M, Ryg J, Speechley M, Sultana M, Tan MP, van der Velde N, Verghese J, Masud T; Task Force on Global Guidelines for Falls in Older Adults
JAMA Netw Open 2021 Dec 1;4(12):e2138911. doi: 10.1001/jamanetworkopen.2021.38911. PMID: 34910151Free PMC Article
Izquierdo M, Merchant RA, Morley JE, Anker SD, Aprahamian I, Arai H, Aubertin-Leheudre M, Bernabei R, Cadore EL, Cesari M, Chen LK, de Souto Barreto P, Duque G, Ferrucci L, Fielding RA, García-Hermoso A, Gutiérrez-Robledo LM, Harridge SDR, Kirk B, Kritchevsky S, Landi F, Lazarus N, Martin FC, Marzetti E, Pahor M, Ramírez-Vélez R, Rodriguez-Mañas L, Rolland Y, Ruiz JG, Theou O, Villareal DT, Waters DL, Won Won C, Woo J, Vellas B, Fiatarone Singh M
J Nutr Health Aging 2021;25(7):824-853. doi: 10.1007/s12603-021-1665-8. PMID: 34409961

Recent clinical studies


Hacıdursunoğlu Erbaş D, Çınar F, Eti Aslan F
Aging Clin Exp Res 2021 Nov;33(11):2953-2966. Epub 2021 Apr 16 doi: 10.1007/s40520-021-01843-w. PMID: 33864235
Ang GC, Low SL, How CH
Singapore Med J 2020 Mar;61(3):116-121. doi: 10.11622/smedj.2020029. PMID: 32488276Free PMC Article
Heng H, Jazayeri D, Shaw L, Kiegaldie D, Hill AM, Morris ME
BMC Geriatr 2020 Apr 15;20(1):140. doi: 10.1186/s12877-020-01515-w. PMID: 32293298Free PMC Article
Callis N
Appl Nurs Res 2016 Feb;29:53-8. Epub 2015 May 22 doi: 10.1016/j.apnr.2015.05.007. PMID: 26856489
Fuller GF
Am Fam Physician 2000 Apr 1;61(7):2159-68, 2173-4. PMID: 10779256


Denfeld QE, Turrise S, MacLaughlin EJ, Chang PS, Clair WK, Lewis EF, Forman DE, Goodlin SJ; American Heart Association Cardiovascular Disease in Older Populations Committee of the Council on Clinical Cardiology and Council on Cardiovascular and Stroke Nursing; Council on Lifestyle and Cardiometabolic Health; and Stroke Council
Circ Cardiovasc Qual Outcomes 2022 Jun;15(6):e000108. Epub 2022 May 19 doi: 10.1161/HCQ.0000000000000108. PMID: 35587567
Heng H, Jazayeri D, Shaw L, Kiegaldie D, Hill AM, Morris ME
BMC Geriatr 2020 Apr 15;20(1):140. doi: 10.1186/s12877-020-01515-w. PMID: 32293298Free PMC Article
Zhang W, Low LF, Schwenk M, Mills N, Gwynn JD, Clemson L
Dement Geriatr Cogn Disord 2019;48(1-2):17-29. Epub 2019 Nov 19 doi: 10.1159/000504340. PMID: 31743907
Khalifa M
Stud Health Technol Inform 2019 Jul 4;262:340-343. doi: 10.3233/SHTI190088. PMID: 31349337
Falcão RMM, Costa KNFM, Fernandes MDGM, Pontes MLF, Vasconcelos JMB, Oliveira JDS
Rev Gaucha Enferm 2019;40(spe):e20180266. Epub 2019 Apr 8 doi: 10.1590/1983-1447.2019.20180266. PMID: 30970105


Sun M, Min L, Xu N, Huang L, Li X
Int J Environ Res Public Health 2021 Nov 29;18(23) doi: 10.3390/ijerph182312562. PMID: 34886293Free PMC Article
Sherrington C, Fairhall N, Kwok W, Wallbank G, Tiedemann A, Michaleff ZA, Ng CACM, Bauman A
Int J Behav Nutr Phys Act 2020 Nov 26;17(1):144. doi: 10.1186/s12966-020-01041-3. PMID: 33239019Free PMC Article
Veronese N, Maggi S, Schofield P, Stubbs B
Maturitas 2017 Aug;102:1-5. Epub 2017 May 4 doi: 10.1016/j.maturitas.2017.05.004. PMID: 28610676
Sherrington C, Michaleff ZA, Fairhall N, Paul SS, Tiedemann A, Whitney J, Cumming RG, Herbert RD, Close JCT, Lord SR
Br J Sports Med 2017 Dec;51(24):1750-1758. Epub 2016 Oct 4 doi: 10.1136/bjsports-2016-096547. PMID: 27707740
Howe TE, Shea B, Dawson LJ, Downie F, Murray A, Ross C, Harbour RT, Caldwell LM, Creed G
Cochrane Database Syst Rev 2011 Jul 6;(7):CD000333. doi: 10.1002/14651858.CD000333.pub2. PMID: 21735380


Wilbur J, Jogerst G, Butler N, Xu Y
BMC Geriatr 2022 May 18;22(1):436. doi: 10.1186/s12877-022-03129-w. PMID: 35585524Free PMC Article
Ye P, Er Y, Wang H, Fang L, Li B, Ivers R, Keay L, Duan L, Tian M
Lancet Public Health 2021 Dec;6(12):e907-e918. doi: 10.1016/S2468-2667(21)00231-0. PMID: 34838197Free PMC Article
Mikos M, Banas T, Czerw A, Banas B, Strzępek Ł, Curyło M
Int J Environ Res Public Health 2021 Aug 2;18(15) doi: 10.3390/ijerph18158167. PMID: 34360462Free PMC Article
Alušík Š, Paluch Z
Vnitr Lek 2021 Winter;67(1):22-25. PMID: 33752397
Taylor CA, Bell JM, Breiding MJ, Xu L
MMWR Surveill Summ 2017 Mar 17;66(9):1-16. doi: 10.15585/mmwr.ss6609a1. PMID: 28301451Free PMC Article

Clinical prediction guides

Omaña H, Bezaire K, Brady K, Davies J, Louwagie N, Power S, Santin S, Hunter SW
Phys Ther 2021 Oct 1;101(10) doi: 10.1093/ptj/pzab173. PMID: 34244801
Jewell VD, Capistran K, Flecky K, Qi Y, Fellman S
Occup Ther Health Care 2020 Oct;34(4):307-319. Epub 2020 Sep 9 doi: 10.1080/07380577.2020.1815928. PMID: 32907452
Vermeiren S, Vella-Azzopardi R, Beckwée D, Habbig AK, Scafoglieri A, Jansen B, Bautmans I; Gerontopole Brussels Study group
J Am Med Dir Assoc 2016 Dec 1;17(12):1163.e1-1163.e17. doi: 10.1016/j.jamda.2016.09.010. PMID: 27886869
Barry E, Galvin R, Keogh C, Horgan F, Fahey T
BMC Geriatr 2014 Feb 1;14:14. doi: 10.1186/1471-2318-14-14. PMID: 24484314Free PMC Article
Morley JE, Malmstrom TK, Miller DK
J Nutr Health Aging 2012 Jul;16(7):601-8. doi: 10.1007/s12603-012-0084-2. PMID: 22836700Free PMC Article

Recent systematic reviews

Morris ME, Webster K, Jones C, Hill AM, Haines T, McPhail S, Kiegaldie D, Slade S, Jazayeri D, Heng H, Shorr R, Carey L, Barker A, Cameron I
Age Ageing 2022 May 1;51(5) doi: 10.1093/ageing/afac077. PMID: 35524748Free PMC Article
Schoberer D, Breimaier HE, Zuschnegg J, Findling T, Schaffer S, Archan T
Worldviews Evid Based Nurs 2022 Apr;19(2):86-93. Epub 2022 Mar 9 doi: 10.1111/wvn.12571. PMID: 35262271Free PMC Article
Sherrington C, Fairhall NJ, Wallbank GK, Tiedemann A, Michaleff ZA, Howard K, Clemson L, Hopewell S, Lamb SE
Cochrane Database Syst Rev 2019 Jan 31;1(1):CD012424. doi: 10.1002/14651858.CD012424.pub2. PMID: 30703272Free PMC Article
Sherrington C, Michaleff ZA, Fairhall N, Paul SS, Tiedemann A, Whitney J, Cumming RG, Herbert RD, Close JCT, Lord SR
Br J Sports Med 2017 Dec;51(24):1750-1758. Epub 2016 Oct 4 doi: 10.1136/bjsports-2016-096547. PMID: 27707740
Cadore EL, Rodríguez-Mañas L, Sinclair A, Izquierdo M
Rejuvenation Res 2013 Apr;16(2):105-14. doi: 10.1089/rej.2012.1397. PMID: 23327448Free PMC Article

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