Falls and frailty share many significant characteristics. Both are important health issues that affect older people, increase with increasing patient age and are multifactorial phenomena associated with adverse health outcomes. There are also important differences. Falls tend to be viewed by health professionals from a positivist perspective, as predictable events which they have a duty to try and prevent. 1 Falls prevention has become an important target of United Kingdom national health policy2 and the focus of dedicated service development. Frailty, on the other hand, still lacks a precise definition3 and is viewed by some as an inevitable consequence of age {related disease processes. 4 The prevention and treatment of frailty, while being fundamental aspirations of many researchers in the ageing field, currently remain enigmatic.

One construct for understanding frailty conceptualizes the frail older person as a complex system on the threshold of breakdown. 5 In this context, falls are more than just antecedents or associates of frailty but are a manifestation of complex system failure. 6 When complex systems fail they exhibit predictable patterns of behaviour and this can shed light on the reason why falls are frequently the ‘atypical’presentation of illness in frail older adults.