Falling Down

We All Fall Down

More than half of elderly patients (65+) who visited an emergency department because of injuries sustained in a fall suffered adverse events — including additional falls, hospitalization, and death — within 6 months. A recent study examined how risk factors predict recurrent falls and adverse events. According to the Center for Disease Control and Prevention (CDC), falls are the highest cause of death related to injury among seniors.

Falls Are Serious and Costly

• One out of five falls causes a serious injury such as broken bones or a head injury.
• Each year, 3 million older people are treated in emergency departments for fall injuries.
• Over 800,000 patients a year are hospitalized because of a fall injury, most often because of a head injury or hip fracture.
• Each year at least 300,000 older people are hospitalized for hip fractures.
• More than 95% of hip fractures are caused by falling, 8 usually by falling sideways.
• Falls are the most common cause of traumatic brain injuries (TBI).
• In 2015, the total medical costs for falls totaled more than $50 billion.11 Medicare and Medicaid shouldered 75% of these costs.

What Can Happen After a Fall?

Many falls do not cause injuries. But one out of five falls does cause a serious injury such as a broken bone or a head injury.4,5 These injuries can make it hard for a person to get around, do everyday activities, or live on their own.

• Falls can cause broken bones, like wrist, arm, ankle, and hip fractures.
• Falls can cause head injuries. These can be very serious, especially if the person is taking certain medicines (like blood thinners). An older person who falls and hits their head should see their doctor right away to make sure they don’t have a brain injury.
• Many people who fall, even if they’re not injured, become afraid of falling. This fear may cause a person to cut down on their everyday activities. When a person is less active, they become weaker, and this increases their chances of falling.
• Of those that fall, there is a higher risk for falling again and other issues as mentioned in the beginning of this article.

What Conditions Make You More Likely to Fall?

Research has identified many conditions that contribute to falling. These are called risk factors. Many risk factors can be changed or modified to help prevent falls. They include:

• Lower body weakness
• Vitamin D deficiency (that is, not enough vitamin D in your system)
• Difficulties with walking and balance
• Use of medicines, such as tranquilizers, sedatives, or antidepressants. Even some over-the-counter medicines can affect balance and how steady you are on your feet.
• Vision problems
• Foot pain or poor footwear
• Home hazards or dangers such as
  • broken or uneven steps, and
  • throw rugs or clutter that can be tripped over.

Most falls are caused by a combination of risk factors. The more risk factors a person has, the greater their chances of falling. Healthcare providers can help cut down a person’s risk by reducing the fall risk factors listed above.

What You Can Do to Prevent Falls

Falls can be prevented. These are some simple things you can do to keep yourself from falling.

• Ask your doctor or healthcare provider to evaluate your risk for falling and talk with them about specific things you can do.
• Ask your doctor or pharmacist to review your medicines to see if any might make you dizzy or sleepy. This should include prescription medicines and over-the-counter medicines.
• Ask your doctor or healthcare provider about taking vitamin D supplements.
• Do exercises that make your legs stronger and improve your balance. Tai Chi is a good example of this kind of exercise.
• Have your eyes checked by an eye doctor at least once a year, and be sure to update your eyeglasses if needed.
• If you have bifocal or progressive lenses, you may want to get a pair of glasses with only your distance prescription for outdoor activities, such as walking. Sometimes these types of lenses can make things seem closer or farther away than they really are.
• Get rid of things you could trip over.
• Add grab bars inside and outside your tub or shower and next to the toilet.
• Put railings on both sides of the stairs.
• Make sure your home has lots of light by adding more or brighter light bulbs.

What is the Bottom Line Regarding Senior Falls

“Our study shows an even higher rate of adverse events than previous studies have,” said lead study author Jiraporn Sri-on, MD, of Navamindradhiraj University in Bangkok, Thailand. “Patients taking psychiatric and/or sedative medications had even more adverse events. This is concerning because these types of drugs are commonly prescribed for elderly patients in community and residential care settings.”

Of patients who visited the emergency department for injuries sustained in a fall:

• 7.7 percent developed adverse events within 7 days
• 21.4 percent developed adverse events within 30 days 
• 50.3 percent developed adverse events within 6 months. 

And within 6 months:

• 22.6 percent had at least one additional fall
• 42.6 percent revisited the emergency department
• 31.1 percent had subsequent hospitalization 
• 2.6 percent had died

So, senior falls are indeed very serious; and the first fall is just the beginning. It is well worth the effort to do all you can to avoid a fall in the first place. This is achieved through good health and fitness, evaluating your medicines, and minimizing the hazards that would increase the risk for a fall.