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There is no question that falls among the
elderly is a national problem.
On the “micro” level, we know this: an older person who
falls goes
through serious medical distress and suffering. Further, we know
that
depending on the nature of the injury, the individual involved
often loses
much if not all of his or her independence and must rely on others
for help.
Finally, we know that families, especially the adult children
who often assume responsibility
for their older parents’ care and well-being, are pulled and
stressed in
ways they never thought would happen and are rarely prepared for.
On the “macro” level, falls are a big health problem in the
United States. As a
courtesy to reporters and editors writing on this topic, I want to
call your attention
to the many facts and statistics I have summarized from the Center
for Disease
Control and Prevention and its National Center for Injury
Prevention and Control
( www.cdc.gov/ncipc/factsheets/falls.htm).
As you read through this summary of “the numbers and the
dollars” or if you go directly to the CDC site (where you’ll
also find the academic citations), please keep this in mind: Even
though some of these studies are from the 1980s and 1990s, they
report on trends and directions.
And one thing is for certain: As we approach 2007 and beyond, the
numbers and dollars reported here will only increase.
The Problem
· Falls are a serious
public health problem among older adults. More than a third of
adults aged 65 years or older fall each year
· Older adults are hospitalized for
fall-related injuries five times more often than
they are for injuries from other causes
· Of those who fall, 20% to 30% suffer
moderate to severe injuries that reduce
mobility and independence, and increase the risk of premature
death
Calculating Cost Estimates
· A recent study of people aged 72
and older found that the average
health care cost of a fall injury was $19,440 (including
hospital, nursing home, emergency
room, and home health care, but not physician services)
· The total cost of all fall
injuries for people age 65 or older in 1994 was $27.3 billion
)
(Englander 1996). By 2020, the cost of fall injuries
is expected to reach $43.8 billion (in current dollars)
Fall-related Fractures
· The most common
fall-related injuries are osteoporotic fractures. These
are fractures of the hip, spine, or forearm.
· A study published in
1994 estimated that total direct medical costs for
osteoporotic fractures among postmenopausal women in the next 10
years would
be more than $61.2 billion
Hip Fractures
· Hospital admissions for
hip fractures among people over age 65 have steadily
increased, from 230,000 admissions in 1988 to 338,000 admissions
in 1999
The number of hip fractures is expected to exceed 500,000 by the
year 2040
· Assuming 5% inflation and
the growing number of hip fractures, the total
annual cost of these injuries is projected to reach $240 billion
by the year 2040
How serious is the problem?
· Among older adults, falls
are the leading cause of injury deaths
and the most common cause of nonfatal injuries and hospital
admissions
for trauma
What outcomes are linked to falls?
· In 2002, nearly 13,000
people ages 65 and older died from fall-related injuries).
More than 60% of people who die from falls are 75 and older
· Of those who fall, 20% to
30% suffer moderate to severe injuries such as
hip fractures or head traumas that reduce mobility and
independence, and
increase the risk of premature death
· Falls are a leading cause
of traumatic brain injuries
· Among older adults, the
majority of fractures are caused by falls
· The most common fractures
are of the vertebrae, hip, forearm, leg, ankle, pelvis, upper arm,
and hand
· In 2000, direct medical
costs totaled $179 million dollars for fatal and $19.3 billion
dollars for nonfatal fall injuries
Who is at risk?
· White men have the
highest fall-related death rates, followed by white women, black
men, and black women
· Women sustain about 80%
of all hip fractures ).
· Among both sexes, hip
fracture rates increase exponentially with age People ages 85
years and older are
10 to15 times more likely to sustain hip fractures than are people
ages 60 to 65.
What is the effect of hip fractures?
· Of all fall-related
fractures, hip fractures cause the greatest number of deaths
and lead to the most severe health problems and reduced quality of
life
· In 1999 in the United
States, hip fractures resulted in approximately 338,000 hospital
admissions
· Most patients with hip
fractures are hospitalized for about one week Up to 25% of
community-dwelling older adults who sustain hip fractures remain
institutionalized for at least a year
· From 2000 to 2040, the
number of people age 65 or older is projected to increase from
34.8 million to 77.2 million. For people over 85, the relative
growth rate is even faster
Given our aging population, by the year 2040, the
number of hip fractures is expected to exceed 500,000
How can seniors reduce their risk of
falling?
Through careful scientific studies, researchers
have identified a number of modifiable risk factors:
· Lower body weakness
· Problems with walking
and balance
· Taking four or more
medications or any psychoactive medications
How can seniors reduce these risks?
· Increasing lower body
strength and improving balance through regular physical activity
Tai Chi is
one type of exercise program that has been shown to be very
effective
· Asking their doctor or
pharmacist to review all their medicines (both prescription and
over-the-counter)
to reduce side effects and interactions. It may be possible to
reduce the number of medications used,
particularly tranquilizers, sleeping pills, and anti-anxiety drugs
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