Falls are common, often dreaded events in the lives of older people. Aside from the obvious injuries and even death that may result, falling can cause wide-ranging consequences including loss of independence, mental decline, and decreased activity and mobility.
Falls are the leading cause of fatal and nonfatal injuries to older people in the United States. Each year, more than 11 million people over age 65 fall -- that's one of every 3 senior citizens. The treatment of injuries and complications associated with falls costs over $20 billion each year. Already a serious national health concern, increases in falls and injuries among older persons could reach epidemic levels as the population ages.
Fortunately, research has shown that most falls are preventable. Many medical risk factors for falling can be controlled. Simple common sense precautions can reduce, if not eliminate, this serious threat to the health and well being of older persons.
Who falls?
Older women, especially Caucasian, are at highest risk. The number of falls and severity of injury increase with age and in seniors who, for whatever reason, experience loss of physical conditioning, mobility, and balance. Users of many prescription and over-the counter medications (polypharmacy) fall more often. Alcohol use often contributes to falling problems. Those with medical conditions affecting balance and walking ability, such as Parkinson's disease, and stroke are also vulnerable.
Where do falls occur?
While you might expect falls to occur with risky activities, such as walking outdoors or in bad weather, most falls (over 60 percent) happen in the home. Falls in the community account for 30 percent, and only 10 percent of falls occur in institutions such as nursing homes. Remember that falls can happen any time, any place, and to anyone -- even when the person is engaging in ordinary activities.
What are the consequences of falling?
Minor injuries, such as bruises, result from 30 to 50 percent of falls in people over 65 years of age. Fractures occur in about 5 percent of all falls and about one-fourth of these involve the hip. Other major injuries needing hospitalization happen in another 2 to 10 percent of falls.
Death from a fall is not common, but complications caused by falls are the leading cause of death from injury in people over age 65. Of falls that cause injury, over 2 percent are fatal.
Another important consequence of falling is not being able to get up after a fall, even without serious injury. Progressive decreases in activity and mobility and fear of future falls can seriously impact daily life.
What causes falling?
Most falls are caused by a combination of factors, some controllable and some not. The causes can be divided into two categories: intrinsic and extrinsic. Intrinsic or internal causes include both normal and abnormal physical changes that occur with aging that affect vision, hearing, and mobility. Acute illness, the effects of medication, and alcohol use, are other intrinsic causes.
Extrinsic or external causes relate to the home and community environment. These causes can be eliminated with simple safety precautions. Psychosocial factors such as loneliness, depression, and fear of falling are also implicated.
Falls and hip fractures
Even though only 1 to 2 percent of all falls result in hip fracture, falls do cause 90 percent of the 300,000 hip fractures that occur each year in the United States. Women have two to three times more hip fractures than men and a 20 percent chance of fracture during a lifetime. After age 50, the hip fracture rate doubles every 5 to 6 years; one-half of women over age 90 have suffered a hip fracture. Only 25 percent will recover fully; 40 percent will need nursing home care, and 20 percent will die within 12 months.
What to do to reduce your risk of falling
1. Get proper medical evaluation and treatment for conditions causing physical changes. Do not assume you are just "getting old."
2. Pay careful attention to home safety hazards and avoid risky behavior. Do not become unduly fearful about falling, as fear will only encourage inactivity and immobility.
3. TAKE ACTION: Inactivity is dangerous. Exercise improves strength, balance, coordination, and flexibility, which can all help you avoid falling in the first place.
Two good books for further reading:
- Successful Aging. The MacArthur Foundation Study. John W. Rowe, M.D., and Robert L. Kahn, Ph.D. Pantheon Books, New York 1998.
- Strong Women Stay Young. Miriam E. Nelson, Ph.D. Bantam Books, New York 1997.
© Copyright 1995-2009 The Cleveland Clinic Foundation. All rights reserved.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 1/3/2005...#6404
