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Learn
About Falls
and Hip Fractures Among Older Adults |
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Falls and Hip Fractures
Among Older Adults
How serious is the problem?
 | In the United States, one of every
three adults 65 years old or older falls each year.1,2 |
| Falls are the leading cause of injury
deaths among people 65 years and older.3 |
| In 1998, about 9,600 people over the
age of 65 died from fall-related injuries.4 |
| Of all fall deaths, more than 60%
involve people who are 75 years or older.3 |
| Fall-related death rates are higher
among men than women and differ by race. White men have the highest
death rate, followed by white women, black men and black women.3 |
What other health outcomes are linked with falls?
| Among older adults, falls are the most
common cause of injuries and hospital admissions for trauma.5
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| Falls account for 87% of all fractures
for people 65 years and older.5 They are also the second
leading cause of spinal cord and brain injury among older adults.6
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| Each year in the United States, one
person in 20 receives emergency department treatment because of a
fall.7 Advanced age greatly increases the chance of a
hospital admission following a fall. |
| Among older adults, fractures are the
most serious health outcomes associated with falls. About 3% of all
falls cause fractures.8 The most common are fractures of
the pelvis, hip, femur, vertebrae, humerus, hand, forearm, leg and
ankle.9 |
Where are people most likely to fall?
For adults 65 years old or older, 60% of
fatal falls happen at home, 30% occur in public places, and 10% occur in
health care institutions.10
What is the impact of hip fractures?
| Of all fractures from falls, hip
fractures cause the greatest number of deaths and lead to the most
severe health problems.11 |
| In 1996, there were approximately
340,000 hospital admissions for hip fractures in the United States.12
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| Women sustain 75% – 80% of all hip
fractures.13 |
| People who are 85 years or older are
10-15 times more likely to experience hip fractures than are people
between the ages of 60 and 65.9 |
| Most patients with hip fractures are
hospitalized for about 2 weeks.14 |
| Half of all older adults hospitalized
for hip fractures cannot return home or live independently after their
injuries.9,13 |
| In 1991, Medicare costs for hip
fractures were estimated to be $2.9 billion.15 |
| Because the U.S. population is aging,
the problem of hip fractures will likely increase substantially over
the next four decades. By the year 2040, the number of hip fractures
is expected to exceed 500,000.16 |
What factors increase older adults’ risk of falling?
| Factors that contribute to falls
include problems with gait and balance, neurological and
musculoskeletal disabilities, psychoactive medication use, dementia,
and visual impairment.17 |
| Environmental hazards such as slippery
surfaces, uneven floors, poor lighting, loose rugs, unstable
furniture, and objects on floors may also play a role.1 |
What can older adults do to reduce their
risk of falling?
| Maintain a regular exercise program.
Exercise improves strength, balance, and coordination.18,19
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| Take steps to make living areas safer.
Remove tripping hazards and use non-slip mats in the bathtub and on
shower floors. Have grab bars put in next to the toilet and in the tub
or shower, and have handrails put in on both sides of all stairs.20
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| Ask their doctor to review all of
their medicines in order to reduce side effects and interactions.21
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| Have an eye doctor check their vision
each year. Poor vision can increase the risk of falling.17 |
References
- Tinetti ME, Speechley M, Ginter SF.
Risk factors for falls among elderly persons living in the community.
New England Journal of Medicine 1988;319(26):1701-7.
- Sattin RW. Falls among older persons:
A public health perspective. Annual Review of Public Health
1992;13:489-508.
- Hoyert DL, Kochanek KD, Murphy SL.
Deaths: Final Data for 1997. National vital statistics reports; vol.
47 no. 19. Hyattsville, Maryland: National Center for Health
Statistics, 1999.
- National Center for Health Statistics
Vital Statistics System, 2000.
- Fife D, Barancik JI. Northeastern Ohio
Trauma Study III: Incidence of fractures. Annals of Emergency Medicine
1985; 14:244-8.
- Kraus KF, Black MA, Hessol N et al.
The incidence of acute brain injury and serious impairment in a
defined population. American Journal of Epidemiology 1984;119:186-201.
- Cummings SR, Kelsey JL, Nevitt MC et
al. Epidemiology of osteoporosis and osteoporotic fractures.
Epidemiology Review 7;1985:178-208.
- Cooper C; Campion G; Melton LJ. Hip
fractures in the elderly: a world-wide projection. Osteoporosis
International 1992;2(6):285-9.
- Scott JC. Osteoporosis and hip
fractures. Rheumatic Diseases Clinics of North America
1990;16(3):717-40.
- Sorock GS. Falls among the elderly:
Epidemiology and prevention. American Journal of Preventive Medicine
1988;4(5):282-8.
- Barancik JI, Chatterjee BF, Greene YC
et al. Northeastern Ohio Trauma Study: I. Magnitude of the problem.
American Journal of Public Health 1983;73:746-51.
- Graves EJ, Owings MF. 1996 Summary:
National Hospital Discharge Survey. Advance data from vital and health
statistics; no. 301. Hyattsville, Maryland: National Center for Health
Statistics, 1998.
- Melton LJ III, Riggs BL. Epidemiology
of age-related fractures, in Avioli LV (ed): The Osteoporotic
Syndrome. New York, Grune & Stratton, 1983, pp 45-72.
- Graves, EJ. 1988 Summary: National
Hospital Discharge Survey. Advance Data from vital and health
statistics; no.185:1-12. Hyattsville, Maryland: National Center for
Health Statistics, 1990.
- CDC. Incidence and costs to Medicare
of fractures among Medicare beneficiaries aged >65
years--United States, July 1991-June 1992. MMWR 1996;45(41):877-83.
- Cummings SR, Rubin SM, Black D. The
future of hip fractures in the United States. Numbers, costs, and
potential effects of postmenopausal estrogen. Clinical Orthopaedics
and Related Research 1990;252:163-66.
- Tinetti ME, Speechley M. Prevention of
falls among the elderly. New England Journal of Medicine
1989;320(16):1055-9.
- Judge JO, Lindsey C, Underwood M, et
al. Balance improvements in older women: effects of exercise training.
Physical Therapy 1993;73(4):254-62, 263-5.
- Lord SR, Caplan GA, Ward JA. Balance,
reaction time, and muscle strength in exercising older women: a pilot
study. Archives of Physical and Medical Rehabilitation
1993;74(8):837-9.
- Tideiksaar R. Preventing falls: home
hazard checklists to help older patients protect themselves.
Geriatrics 1986;41(5):26-8.
- Ray W, Griffin MR. Prescribed
medications and the risk of falling. Topics in Geriatric
Rehabilitation 1990;5:12-20.
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