Clinical overview of instability in the elderly.

Falling is often a multifactorial syndrome that can be viewed from several perspectives, including pathophysiologic, biomedical, functional, and ecologic models. The history, physical examination, and performance testing are the cornerstones of evaluation. Diagnostic testing in selected cases and environmental evaluation when feasible are additional elements. Management is directed toward correcting reversible problems, improving deficits amenable to partial correction, and providing adaptation to fixed deficits.