Falls and Hip Fractures Among Older Adults
Debbie Wilburn 4/12/06
How serious is the problem?
• More than one-third of adults ages 65 years and older fall each year.
• Among older adults, falls are the leading cause of injury deaths and the most common cause of nonfatal injuries and hospital admissions for trauma.
• In 2003 more than 1.8 million seniors age 65 and older were treated in emergency departments for fall-related injuries and more than 421,000 were hospitalized (CDC 2005).
What outcomes are linked to falls?
• In 2002, nearly 13,000 people ages 65 and older died from fall-related injuries (CDC 2004). 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.
• Among people ages 75 years and older, those who fall are four to five times more likely to be admitted to a long-term care facility for a year or longer.
• Falls are a leading cause of traumatic brain injuries.
• Among older adults, the majority of fractures are caused by falls.
• Approximately 3% to 5% of older adult falls cause fractures. Based on the 2000 census, this translates to 360,000 to 480,000 fall-related fractures each year.
• The most common fractures are of the vertebrae, hip, forearm, leg, ankle, pelvis, upper arm, and hand.
Who is at risk?
• White men have the highest fall-related death rates, followed by white women, black men, and black women (CDC 2004).
• 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.
• In 2000, direct medical cost totaled $179 million dollars for fatal and $19 billion dollars for nonfatal fall injuries. (CDC 1996).
• 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 (U.S. Bureau of the Census 1998). 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
Seniors can modify these risk factors by:
• Increasing lower body strength and improving balance through regular physical. 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
• Strong studies have shown that some other important fall risk factors are Parkinson's Disease, history of stroke, arthritis, cognitive impairment, and visual impairments. To reduce these risks, seniors should see a health care provider regularly for chronic conditions and have an eye doctor check their vision at least once a year.
What other things may help reduce fall risk?
Because seniors spend most of their time at home, one-half to two-thirds of all falls occur in or around the home. Most fall injuries are caused by falls on the same level (not from falling down stairs) and from a standing height (for example, by tripping while walking). Therefore, it makes sense to reduce home hazards and make living areas safer.
• Researchers have found that simply modifying the home does not reduce falls. However, environmental risk factors may contribute to about half of all home falls.
• Common environmental fall hazards include tripping hazards, lack of stair railings or grab bars, slippery surfaces, unstable furniture, and poor lighting
To make living areas safer, seniors should:
• Remove tripping hazards such as throw rugs and clutter in walkways;
• Use non-slip mats in the bathtub and on shower floors;
• Have grab bars put in next to the toilet and in the tub or shower;
• Have handrails put in on both sides of stairways;
• Improve lighting throughout the home.
Source: National Center for Injury Prevention and Control www.cdc.gov/ncipc
Debbie Wilburn is County Agent/Family and Consumer Science Agent with the Hall (770)535-8290 and the Forsyth (770)887-2418 County Extension Service.