Understanding Falls

While everyone takes a fall occasionally by tripping over an object or walking on a wet surface, the severity of injuries for older adults can result in hip fracture, loss of mobility, permanent reduction in physical ability, or traumatic brain injury.  In fact, falls are the leading cause of injury-related deaths, especially among the elderly, according to the Centers for Disease Control and Prevention.  The CDC reports in a recent survey that nearly 85% of deaths resulting from falls were among people aged 75 and older.

A number of factors can be linked to falls among older adults, and in combination, increase the risk significantly. These include physical and/or cognitive deficits, medication side effects, and potentially unsafe home environments, among others.

Understanding Falls will provide an overview of some of the most common factors related to falls in the older population: Balance, Vision, Hearing, Medication Management, Living Environment, and Footwear, which can be accessed by clicking on the topic in the sidebar.

Learning Objectives:

  • Describe the importance of falls prevention and present key statistics associated with falls, outcomes and results related to falls
  • Identify and describe physical factors influencing the risk of falls for the older population
  • Identify and describe environmental factors which increase the risk of falls for the older population

Importance of Understanding Falls

In any given year, an estimated one-third of people 65 and older, and nearly one-half 85+, will have a fall.  What are the consequences?

What happens after a fall?

  • 15-20% of falls lead to an injury;
  • 5-10% result in hip fracture, with most of those patients never regaining their prior level of functioning;
  • An estimated 10% will die of complications related to a fall. 

The financial cost?

  • Falls are associated with 40% of admissions to long-term care facilities;
  • 70% of emergency room visits by people 75 years and older are fall-related;
  • In 2000, the total direct cost of all fall injuries for people 65 and older exceeded $19 billion: $0.2 billion for fatal falls, and $19 billion for nonfatal falls.
  • By 2020, the annual direct and indirect cost of fall injuries is expected to reach $54.9 billion (in 2007 dollars), nearly tripling in 20 years.

References

  1. Centers for Disease Control and Prevention (2006).  National Center for Injury Prevention and Control.  Web–based Injury Statistics Query and Reporting System (WISQARS). Available at: www.cdc.gov/ncipc/wisqars. Accessed October 7, 2009.
  2. Englander F, Hodson TJ, Terregrossa RA. Economic dimensions of slip and fall injuries. Journal of Forensic Science 1996;41(5):733–46.
  3. Ganz DA, Yeran B, Shekelle PG, Rubenstein LA. Will My Patient Fall? Journal of the American Medical Association. 2007;297:77-86.
  4. Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of fatal and nonfatal falls among older adults. Injury Prevention 2006;12:290–5.
  5. Tinetti ME. Clinical practice: preventing falls in elderly persons. N Engl J Med. 2003;348:42-49.
  6. Rubenstein LZ, Josephson KR. The epidemiology of falls and syncope. Clin Geriatr Med. 2002;18:141-158.