In May 2015, the U.S. Centers for Disease Control and Prevention (CDC) released its mortality report showing that the only increase in unintentional injury that lead to mortality was due to falls among older adults. While all other causes of mortality remained fairly stable, between 2000 and 2013, death from falls in older adults nearly doubled, from 30 to 57 deaths per 100,000 older adults. In any given year, one in three older adults will have a fall and 20-30% of these victims will suffer a moderate or severe injury. A quarter will die before the year is over. This is a public health tragedy.
Men are 40% more likely than women to die from a fall. While older Whites are 2.7 times more likely to die from falls as their Black counterparts.
Falls are the most common cause of traumatic brain injuries (TBI).5
Half of all fatality because of falls are due to TBI.7
The most common injuries when older fall are fractures to spine, hip, forearm, leg, ankle, pelvis, upper arm, and hand. Of these, the most serious is hip fracture. In a large number of cases leading to death. In contradiction, although falls remains on the increase from 1996 to 2010, hip fracture rates declined significantly for men and women (13). Over 95% of hip fractures are caused by falls. It is not known what factors are contributing to this trend. This seemingly contradictory evidence
A woman's bone density declines by about 30% between the ages of 50 and 80 increasing 5 years after menopause. Although bone density is not the only factor in hip fracture risk. Over 90% of hip fractures occur upon falling. Although many elderly people suffer spontaneous hip fractures because of advanced osteoporosis, the immediate cause is a fall. But this information is not validated. If a fall was instigated by a spontaneous hip fracture, the older adult is more likely to find an "excuse" for the fall rather than accept (and understand the mechanics) or a spontaneous fracture. There are distinct breaks if it is due to a fall or due to a spontaneous hip fracture.
Falls can be complex, and the literature has numerous causal pathways--from increased medication, older and frailer adults, better reporting, better health surveillance, heavier older adults--all of which are valid. But there is one cause that is not mentioned.
Most researchers assume that an older adult fall and then break their hip. Or if they fall, they try and find behavioral reasons for the fall. However it is also likely that there is a spontaneous hip fracture which causes the older adult to fall. There is a spontaneous hip fracture and then the person falls. Such fracture can easily be determined. As yet CDC has not undertaken this study. It would be relatively easy to review the X-rays from those that died. This study would not even need an Institutional Review Board. But until that study is done we can only conjecture the cause of these hip fractures.
It could be that there is an environmental cause to the increase in fractures related to state policies that the Federal agency supports: fluoridation of our water. There is overwhelming evidence that fluoridation in our water is toxic. Although the topical application of fluoride on teeth has been found to be beneficial, the ingestion of fluoride continues to receive negative outcomes. The argument that it improves dental health becomes less realistic when more than a quarter of adults over the age of 60 have dentures. The fact that this policy of water fluoridation ignored older adult health is already established. What is being established now is that it is harmful to older adults.
One of the reasons why falls are on the increase is because the bones of older adults in the U.S. are being made brittle because of fluoridation of water and that these spontaneous fractures are causing some or most of the falls. Multiple studies support this assertion: Fluoride therapy may be implicated in the pathogenesis of hip fractures which may occur in treated patients despite a rapid, marked increase in bone mass. (6) Fluoride appears to be a key factor in the pathogenesis of stress fractures (7) [T]he six hip fractures occurring in patients receiving fluoride during 72.3 patient years of treatment is 10 times higher than would be expected in normal women of the same age (8) Thirteen cases of spontaneous fissure or fracture of the lower limbs observed in 8 patients under treatment with sodium fluoride are reported (9). (Fluoridation)...to worsen a patient’s clinical state (1) Increasing the dose of fluoride increases the risk of nonvertebral fractures (2) 1 year of fluoride administration seemed to reduce bone strength by 17-30% (3) patients treated with sodium fluoride,...All fractures were spontaneous in onset... three times that in untreated osteoporosis. (4) Fluoride treatment was “associated with a significant three-fold increase in the incidence of nonvertebral fractures (5) fluoride-induced microfractures (10)
Men are 40% more likely than women to die from a fall. While older Whites are 2.7 times more likely to die from falls as their Black counterparts.
Falls are the most common cause of traumatic brain injuries (TBI).5
Half of all fatality because of falls are due to TBI.7
The most common injuries when older fall are fractures to spine, hip, forearm, leg, ankle, pelvis, upper arm, and hand. Of these, the most serious is hip fracture. In a large number of cases leading to death. In contradiction, although falls remains on the increase from 1996 to 2010, hip fracture rates declined significantly for men and women (13). Over 95% of hip fractures are caused by falls. It is not known what factors are contributing to this trend. This seemingly contradictory evidence
A woman's bone density declines by about 30% between the ages of 50 and 80 increasing 5 years after menopause. Although bone density is not the only factor in hip fracture risk. Over 90% of hip fractures occur upon falling. Although many elderly people suffer spontaneous hip fractures because of advanced osteoporosis, the immediate cause is a fall. But this information is not validated. If a fall was instigated by a spontaneous hip fracture, the older adult is more likely to find an "excuse" for the fall rather than accept (and understand the mechanics) or a spontaneous fracture. There are distinct breaks if it is due to a fall or due to a spontaneous hip fracture.
Falls can be complex, and the literature has numerous causal pathways--from increased medication, older and frailer adults, better reporting, better health surveillance, heavier older adults--all of which are valid. But there is one cause that is not mentioned.
Most researchers assume that an older adult fall and then break their hip. Or if they fall, they try and find behavioral reasons for the fall. However it is also likely that there is a spontaneous hip fracture which causes the older adult to fall. There is a spontaneous hip fracture and then the person falls. Such fracture can easily be determined. As yet CDC has not undertaken this study. It would be relatively easy to review the X-rays from those that died. This study would not even need an Institutional Review Board. But until that study is done we can only conjecture the cause of these hip fractures.
It could be that there is an environmental cause to the increase in fractures related to state policies that the Federal agency supports: fluoridation of our water. There is overwhelming evidence that fluoridation in our water is toxic. Although the topical application of fluoride on teeth has been found to be beneficial, the ingestion of fluoride continues to receive negative outcomes. The argument that it improves dental health becomes less realistic when more than a quarter of adults over the age of 60 have dentures. The fact that this policy of water fluoridation ignored older adult health is already established. What is being established now is that it is harmful to older adults.
One of the reasons why falls are on the increase is because the bones of older adults in the U.S. are being made brittle because of fluoridation of water and that these spontaneous fractures are causing some or most of the falls. Multiple studies support this assertion: Fluoride therapy may be implicated in the pathogenesis of hip fractures which may occur in treated patients despite a rapid, marked increase in bone mass. (6) Fluoride appears to be a key factor in the pathogenesis of stress fractures (7) [T]he six hip fractures occurring in patients receiving fluoride during 72.3 patient years of treatment is 10 times higher than would be expected in normal women of the same age (8) Thirteen cases of spontaneous fissure or fracture of the lower limbs observed in 8 patients under treatment with sodium fluoride are reported (9). (Fluoridation)...to worsen a patient’s clinical state (1) Increasing the dose of fluoride increases the risk of nonvertebral fractures (2) 1 year of fluoride administration seemed to reduce bone strength by 17-30% (3) patients treated with sodium fluoride,...All fractures were spontaneous in onset... three times that in untreated osteoporosis. (4) Fluoride treatment was “associated with a significant three-fold increase in the incidence of nonvertebral fractures (5) fluoride-induced microfractures (10)
sustained spontaneous bilateral hip fractures during treatment with fluoride, calcium, and vitamin D for osteoporosis (11) Three or four of the fractures in the fluoride group appeared to be spontaneous hip fractures...the fluoride treatment here was probably partly responsible for the fractures in our cases. (12)
CDC needs to review the X-rays of all older adults that die due to falls. Ascertain the level of spontaneous hip fractures. Examine the correlation with fluoridation in the public water system. Measure the accumulation of fluoride in older adults. Engage in a systematic review of fluoridation on older adult comprehensive health including skeletal, digestive system and neurological.
CDC needs to review the X-rays of all older adults that die due to falls. Ascertain the level of spontaneous hip fractures. Examine the correlation with fluoridation in the public water system. Measure the accumulation of fluoride in older adults. Engage in a systematic review of fluoridation on older adult comprehensive health including skeletal, digestive system and neurological.
- There is no correlation among countries that fluoridate their water and hip fractures.
In 2002 in an international comparative study John Kanis from the WHO Collaborating Center for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, United Kingdom and his colleagues reported some dramatic variance in hip fracture incidence from different regions of the world. Lifetime risk at the age of 50 years varied from 1% in women from Turkey to 28.5% in women from Sweden. The risk for women was correlated with that for men. Countries were categorized by 10-year probabilities comprising very high risk (Norway, Iceland, Sweden, Denmark, and the United States), high risk (Taiwan, Germany, Switzerland, Finland, Greece, Canada, The Netherlands, Hungary, Singapore, Italy, United Kingdom, Kuwait, Australia, and Portugal), medium risk (Hong Kong, France, Japan, Spain, Argentina, and China), and low risk (Turkey, Korea, Venezuela, and Chile). Only 6 OECD countries have more than 50% of their populations drinking fluoridated water: Australia (80%), Chile (70%), the Irish Republic (73%), Israel (70%), New Zealand (61%), and the United States (64%).
1. Gutteridge DH, et al. (2002). A randomized trial of sodium fluoride (60 mg) +/- estrogen in postmenopausal osteoporotic vertebral fractures: increased vertebral fractures and peripheral bone loss with sodium fluoride; concurrent estrogen prevents peripheral loss, but not vertebral fractures. Osteoporosis International 13:158-70.
2. Haguenauer D, et al. (2000). Fluoride for the treatment of postmenopausal osteoporotic fractures: a meta-analysis. Osteoporosis International 11:727-38.
3 Sogaard CH, et al. (1994). Marked decrease in trabecular bone quality after five years of sodium fluoride therapy–assessed by biomechanical testing of iliac crest bone biopsies in osteoporotic patients. Bone 15: 393-99.
4. Schnitzler CM, et al. (1990). Bone fragility of the peripheral skeleton during fluoride therapy for osteoporosis. Clinical Orthopedics (261):268-75.
5. Riggs BL, et al. (1990). Effect of Fluoride treatment on the Fracture Rates in Postmenopausal Women with Osteoporosis. New England Journal of Medicine 322:802-809.
6. Bayley TA, et al. (1990). Fluoride-induced fractures: relation to osteogenic effect. Journal of Bone and Mineral Research 5(Suppl 1):S217-22.
7. Orcel P, et al. (1990). Stress fractures of the lower limbs in osteoporotic patients treated with fluoride. Journal of Bone and Mineral Research 5(Suppl 1): S191-4.
8. Hedlund LR, Gallagher JC. (1989). Increased incidence of hip fracture in osteoporotic women treated with sodium fluoride. Journal of Bone and Mineral Research 2:223-5.
9. Orcel P, et al. (1987). [Spontaneous fissures and fractures of the legs in patients with osteoporosis treated with sodium fluoride]. Presse Med 16:571-5.
10. Dambacher MA, et al. (1986). Long-term fluoride therapy of postmenopausal osteoporosis. Bone 7: 199-205.
11. Gerster JC, et al. (1983). Bilateral fractures of femoral neck in patients with moderate renal failure receiving fluoride for spinal osteoporosis. British Medical Journal (Clin Res Ed). 287(6394):723-5.
12. Inkovaara J, et al. (1975). Phophylactic fluoride treatment and aged bones. British Medical Journal 3: 73-74.
13. Stevens JA, Rudd RA. The impact of decreasing U.S. hip fracture rates on future hip fracture estimates. Osteoporosis International 2013. DOI 10.1007/s00198-013-2375-9.
13. Stevens JA, Rudd RA. The impact of decreasing U.S. hip fracture rates on future hip fracture estimates. Osteoporosis International 2013. DOI 10.1007/s00198-013-2375-9.
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