Falling in the Elderly

• Every year, one-third to one-half of the population age 65 and over experience falls.^1-5
• About one third of the population age 65 and over reports some difficulty with balance or ambulation; incidences increase in frequency and severity in the over age 75 population.⁵
• Falls are a leading cause of fatal and nonfatal injuries in older adults.^{2, 6-9}
• In 2000, 1.6 million seniors were treated in emergency departments for fall-related injuries and 353,000 were hospitalized.¹⁰
• The medical expense related to falls amounts to more than $20 billion annually in the US, and is projected to climb in to $32 billion annually by 2020.^2,9,11
• The elderly represent more than one third of all hospital injury admissions, and more than 80% of these injuries are caused by unintentional falls.¹²
• In 1998, 17.2 persons per 100,000 aged 65-84 suffered a fall; and 107.9 per 100,000 aged 85 and older fell.¹³
• More than 300,000 hospitalizations for hip fractures occur annually in the United States; 86% occur in individuals aged 65 and older.^9,14
• Many of the hip fractures sustained in elderly Americans as a result of falls are related to balance disorders.¹⁵
• Fear of falling may negatively impact postural control, thereby completing a vicious loop.¹¹
• Nearly 20% of Americans between the ages of 65 and 75 suffer from balance disorders; by age 75, that figure rises to 25%.¹⁶
• The elderly seek treatment for dizziness more frequently than for hearing loss.¹⁷
• Dizziness is reported to be the most common complaint for patients over 75 years of age.¹⁸
• Of all falls suffered by the elderly, 50% are reported to be the result of vestibular problems.¹⁶
• Approximately 1/4 to 1/3 of the elderly complain of some form of dizziness.¹⁹
• Falls frequently go unreported and undetected and many may be associated with reversible factors.²⁰
• Elderly individuals with Diabetes mellitus (DM) may be at increased risk for injurious falls; DM is highly prevalent in adults over 65 years of age.²⁰
• Older women with diabetes have an increased risk of falling.²¹

References:

1. Coogler, CE. Falls and imbalance. Rehab Management, April/May 1992.
2. American Academy of Orthopedic Surgeons. Fact Sheet: Don't let a fall beyour last trip. http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=74&topcategory=Prevent%20Falls&all=all. Accessed March 2003.
3. Hausdorff JM, Rios DA, Edelber HK. Gait variability and fall risk in community-living older adults: a 1-year prospective study. Archives of Physical Medicine and Rehabilitation 2001;82(8):1050-6.
4. Hornbrook MC, Stevens VJ, Wingfield DJ, Hollis JF, Greenlick MR, Ory MG. Preventing falls among community-dwelling older persons: Results from a randomized trial. The Gerontologist 1994; 34(1):16-23.
5. Rubenstein LZ. Falls and Balance Problems. Patient Education Forum, American Geriatrics Society. http://www.americangeriatrics.org/education/forum/falling.shtml. Accessed March 2003.
6. Murphy SL. Deaths: Final data for 1998. National Vital Statistics Reports, vol. 48, no. 11. Hyattsville (MD): National Center for Health Statistics; 2000.
7. Alexander BH, Rivara FP, Wolf ME. The cost and frequency of hospitalization for fall-related injuries in older adults. American Journal of Public Health 1992; 82(7):1020-3.
8. Klein K, and Ritzel DO. Falls Pose a Serious Threat to the Elderly. National Safety Council - Falls in the Home. http://www.nsc.org/issues/ifalls/falthreat.htm. Accessed March 2003.
9. Centers for Disease Control. Falls Among Older Adults. Injury Fact Book 2001-2002. www.cdc.gov/ncipc/fact_book/15_Falls_Among_Older_Adults.htm. Accessed March 2003.
10. Centers for Disease Control. Web-based Injury Statistics Query and Reporting System (WISQARS) [database online]. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (producer). www.cdc.gov/ncipc/wisqars (2001).
11. Bloem, et al. An Update on Falls: Curr Opin Neurol, 2003; Vol 16(1):15-26.
12. Greenwald BD, et al (2003). Congenital and Acquired Brain Injury. 1. Brain Injury: Epidemiology and Pathophysiology. Arch Phys Med Rehabil Vol 84, Suppl 1, March 2003, S3-S7.
13. University of Pittsburgh. http://www.pitt.edu/~kaf24/table.html. Accessed July 2003.
14. Braithwiate RS, et al. Estimating Hip Fracture Morbidity, Mortality and Costs. JAGS 51:364-370, 2003.
15. National Institute on Deafness and Other Communication Disorders, March 1997.
16. Biology Seminar presented to NASA headquarters by Dr. James F. Battey, Director, National Institute on Deafness; June 1998.
17. Desmond. Advance for Audiologists. July/August 2000.
18. Ator GA. University of Kansas Department of Otolaryngology Division of Otology Talk: Vertigo - Evaluation and Treatment in the Elderly. http://www2.kumc.edu/otolaryngology/otology/VertEldTalk.htm. Accessed Mar 2003.
19. University of Iowa Health Care. Comprehensive management of vestibular disorders. Currents: Spring 2002, Vol 3, No 2. http://www.uihealthcare.com/news/currents/vol3issue2/03vertigo.html. Accessed Mar 2003.
20. California Healthcare Foundation/American Geriatrics Society Panel on Improving Care for Elders with Diabetes. Guidelines for Improving the Care of the Older Person with Diabetes Mellitus. JAGS 51:S265-S280, 2003.
21. Schwartz AV, Hillier TA, et al. Older Women with Diabetes Have a Higher Risk of Falls. Diabetes Care 25:1749-1754, 2002.

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