Preventing Falls in Older Americans

They’re the leading cause of injury and death.

By Dr. Kevin Campbell | Contributor Oct. 26, 2016, at 6:00 a.m.

Senior woman lying on the floor after accident.

Falls are the leading cause of traumatic brain injuries in the U.S. (GETTY IMAGES)

According to a new report by the Centers for Disease Control, the leading cause of death among older Americans in the United States is falls. The rate of significant falls in those over age 65 has been steadily increasing over the last several years. Last year, there were 29 million falls in this age group, resulting in nearly 7 million injuries. In fact, of these 7 million injuries, 2.8 million patients were seen in emergency rooms, and almost 800,000 were admitted to the hospital as a direct result of the fall. Sadly, 27,000 deaths occurred due to these fall-related injuries last year. Currently, nearly 1 in 4 Americans over the age of 65 experiences a fall each year, and once a first fall occurs, the likelihood of a second fall doubles. Falls have a significant financial impact on health care as well – they account for nearly $31 billion dollars in health care expenditures annually.

What Type of Injuries Are Associated With Falls?

For the most part, broken bones are the most common injury associated with falls. Broken arms, wrists and hips are frequent consequences of falls. In fact, 95 percent of all hip fractures in the U.S. today are due to falls. Hip fractures in particular are associated with significant morbidity and mortality. Often, a fall resulting in a fracture in an older patient can begin a cascade of negative health events – including hospital-acquired infections, debilitation and limited mobility. Many previously independent adults are not able to go home to an independent living situation following a catastrophic fall-related injury.

Another common result of a fall that can be potentially life-threatening is a head injury. When older adults fall, they may strike their head, which can result in a concussion or bleeding inside the brain. Many older Americans are on multiple medications, and some medications make bleeding more likely. Falls are the leading cause of traumatic brain injuries in the U.S. today.

 What Are the Root Causes of Falls?

Most falls are preventable. The most common causes of falls fall into two categories – pre-existing conditions that put you at higher risk and environmental conditions. According to the CDC, older adults who are de-conditioned or those with vitamin D deficiencies are at very high risk for a fall-related fracture. In addition, those with vision problems or balance difficulties from any etiology are also at high risk. Environmental conditions that predispose adults to falls include ill-fitting footwear, the presence of throw rugs, uneven flooring or steps and over-medicating with sedation prone drugs. Many of these issues are reversible if they are addressed by health care providers, family and friends. Unfortunately, many adults do not report falls and keep them a secret for fear of upsetting family. Many are fearful that reporting a fall may result in interventions that could lead to them giving up their independence.

What Can We Do to Reverse the Trend and Prevent Falls?

The key to reducing the mortality and morbidity associated with falls is better education and prevention. First of all, both physicians as well as patients must ask about and discuss mobility issues in the home. While many older Americans may be reluctant to discuss the consequences of growing older, it is vital that these discussions take place in order to prevent serious complications. As we continue to age as a country and the baby boomers become the dominant part of the older population, we will see more and more fall-related injuries. Here are some simple strategies to prevent falls:

1. Talk to your doctor or health care provider. Determine what your risk for falls may be. Make sure your bone strength has been assessed, and if you have osteoporosis or are at risk for osteoporosis, begin therapy to prevent its progression. Make sure you review your medications with your pharmacist and ensure that you’re aware of any drugs that may make you sleepy or have side effects that can affect balance or gait.

2. Exercise. It is essential to work on strength and balance when you work out. Developing core muscles and working on balance can improve your ability to avoid falls. In addition, these types of exercises can sharpen your mental abilities and may actually slow the development of any age-related dementia.

3. Get an eye exam. Many of us are quite good at adapting to changing eyesight conditions. It is very important to see an eye doctor yearly for an exam. As we age, our eyes change and current eyeglass or contact prescriptions may be inadequate. Changes in our vision can result in impaired depth perception, and this can be a real risk factor for falls – especially when walking up or down steps.

4. Do a home safety check and makeover. There are many dangers that may be lurking in our homes. Throw rugs and other loose floor coverings are a common reason that many adults fall. They simply get their feet tangled in a rug and may topple over. As you age and balance and dexterity become more impaired, it’s important to install handrails in bathrooms near toilets and in showers. Make sure there are bright lights throughout the home. In addition, if you have lots of stairs, have railings installed on both sides of the stairs and remove any items that may be on the steps.

Health care costs in the U.S. continue to rise, and it’s essential that we focus more on prevention. As medical care continues to advance and more treatments exist for previously incurable or deadly disease, it’s a shame that a simple fall can have such a negative impact. Falls, while contributing significantly to poor health status in older Americans, are completely preventable. Make it a priority to talk with friends and family about prevention today.

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