Falls Among Older Adults: An Overview
Each year, one in every three adults age 65 and older falls. Falls can cause moderate to severe injuries, such as hip fractures and head injuries, and can increase the risk of early death. Fortunately, falls are a public health problem that is largely preventable.
How big is the problem?
- One out of three adults age 65 and older falls each year, but less than half talk to their healthcare providers about it.
- Among older adults (those 65 or older), falls are the leading cause of injury death. They are also the most common cause of nonfatal injuries and hospital admissions for trauma.
- In 2010, 2.3 million nonfatal fall injuries among older adults were treated in emergency departments and more than 662,000 of these patients were hospitalized.
- In 2010, the direct medical costs of falls, adjusted for inflation, was $30.0 billion.
What outcomes are linked to falls?
Twenty to thirty percent of people who fall suffer moderate to severe injuries such as lacerations, hip fractures, or head traumas. These injuries can make it hard to get around or live independently, and increase the risk of early death.
- Falls are the most common cause of traumatic brain injuries (TBI).7 In 2000, TBI accounted for 46% of fatal falls among older adults.
- Most fractures among older adults are caused by falls.8 The most common are fractures of the spine, hip, forearm, leg, ankle, pelvis, upper arm, and hand.
- Many people who fall, even if they are not injured, develop a fear of falling. This fear may cause them to limit their activities, which leads to reduced mobility and loss of physical fitness, and in turn increases their actual risk of falling.
Who is at risk?
- The death rates from falls among older men and women have risen sharply over the past decade.
- In 2009, about 20,400 older adults died from unintentional fall injuries.
- Men are more likely than women to die from a fall. After taking age into account, the fall death rate in 2009 was 34% higher for men than for women.
- Older whites are 2.4 times more likely to die from falls as their black counterparts.
- Rates also differ by ethnicity. Older non-Hispanics have higher fatal fall rates than Hispanics.
- People age 75 and older who fall are four to five times more likely than those age 65 to 74 to be admitted to a long-term care facility for a year or longer.
- Rates of fall-related fractures among older women are more than twice those for men.
- Over 95% of hip fractures are caused by falls. In 2009, there were 271,000 hip fractures and the rate for women was almost three times the rate for men.
- White women have significantly higher hip fracture rates than black women.
How can older adults prevent falls?
Older adults can remain independent and reduce their chances of falling. They can:
- Exercise regularly. It is important that the exercises focus on increasing leg strength and improving balance, and that they get more challenging over time. Tai Chi programs are especially good.
- Ask their doctor or pharmacist to review their medicines—both prescription and over-the counter—to identify medicines that may cause side effects or interactions such as dizziness or drowsiness.
- Have their eyes checked by an eye doctor at least once a year and update their eyeglasses to maximize their vision. Consider getting a pair with single vision distance lenses for some activities such as walking outside.
- Make their homes safer by reducing tripping hazards, adding grab bars inside and outside the tub or shower and next to the toilet, adding railings on both sides of stairways and improving the lighting in their homes.
To lower their hip fracture risk, older adults can:
- Get adequate calcium and vitamin D—from food and/or from supplements.
- Do weight bearing exercise.
- Get screened and, if needed, treated for osteoporosis.
As an accredited attorney with the Veterans Administration, a member of the National Academy of Elder Law Attorneys, and the Washington State Bar Association, Elder Law Section, Darol Tuttle of Washington State, has helped numerous families plan for the future and protect their assets.