Falling for You

Falling is the leading cause of injury hospitalization and death among Americans aged 65 and older. Fall injuries, including hip fractures, deep bruises and head trauma, represent a growing public health problem that remains under-recognized and under-treated. Sadly, all falls are preventable.

Each year, falls occur for more than one in three (35% -40%) of older Americans who live at home. The older you are the more likely you are to fall.  In nursing homes and hospitals, rates triple (1.5 falls per bed annually). Women sustain about 80% of all hip fractures.  In 2000, the total costs of treating fall-related injuries among older Americans exceeded $19 billion. By 2020, these numbers are expected to climb to $59 billion as a consequence of the growing number of aging baby boomers.

Self-imposed activity limitations from the fear of falling affect more than half of all community-dwelling older adults, leading to increased risks for further falls, depression, social isolation, and a drastic decline in quality of life. In a study of 540 community-living adults aged 70 years and older, Jolanda van Haastregt and colleagues reported that more than half of all study participants said they fell at least once in the previous six months. More than one in four (28%) said they had severe fear of falling and severe avoidance of physical activity.

In 2009, one out of every 27 older adults aged 85 and older called 911 in San Diego County because of a fall. Falling was the fourth most common pre-hospital call, resulting in nearly one in ten of all calls (5,606 in 2009). Falls remain the leading cause of unintentional injury hospitalization for those over 55 years. In 2006 in San Diego County, two thirds of all falls occurred at home--nearly half from slipping (43%). Of these, “emergency room discharge with a fall injury” was highest for the east county cities of Lemon Grove, La Mesa and El Cajon. SANDAG projects that the older adult population for 2015 for San Diego county would be 435,805 it is expected that one in three (145,268) will fall that year. Of these, three out of four will fall a second time.

Aside from substantial medical cost, the individual cost involves more than money. Fall-related injuries are often single most common event that alter mobility and limit independent living.  Many fall injuries, such as hip fractures, increase the risk of premature death. For example, a recent survival analysis of men and women aged 50-plus years who had a hip fracture concluded that hip fractures increased all-cause mortality 5- to 8-fold during the first three months after the injury. Such negative outcomes persist over time. Life is not the same once you have had a significant fall.

Falling does not have to be a death sentence. Many of these risk factors are manageable and potentially correctable. Sensory problems and medications can be address with your health care provider. Since gait and balance problems are strong predictors of falls, yoga, exercise, and the use of assistive devices can reduce the likelihood of a fall.