Preventing Falls among Elders-A $20 Billion a Year Challenge

By Thompson, April | Aging Today, September/October 2002 | Go to article overview

Preventing Falls among Elders-A $20 Billion a Year Challenge


Thompson, April, Aging Today


One of every three older Americans-- about 12 million people-fall each year. Although most fall from a standing position rather than from a height, the impact of that fall can be devastating. Of the approximately 13,000 Americans who die from falls every year, more than 10,000 are 65 or older. Another 340,000 adults, mainly those older than 65, fall and fracture a hip.

"A fall is a potentially life-changing event for an older person. Older adults can't bounce back from an injury like a younger person can," said Christine Branche, director of the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control (NCIPC). Located in Atlanta, NCIPC is part of the national Centers for Disease Control and Prevention (CDC).

A LEADING MORTALITY CAUSE

CDC is heading efforts to address older adults' risk for injuries, especially falls, which are the leading cause of injury-related death among the older population. The agency funds research on the causes and prevention of falls and fall-related injuries, educational efforts, and state and local projects to develop and evaluate community interventions.

Hip fractures are one of the most serious consequences of falling, according to CDC. Half of older adults can no longer care for themselves after a hip fracture, and a quarter will die within a year of the injury. "A lot of people don't ever recover from a hip fracture. It's slow to heal and takes a lot of work to regain independence," stressed Judy Stevens, an epidemiologist at CDC.

A broken hip also carries a high price tag: $ 16,300 to $ 18,700 during the first year after the injury. The estimated cost is even higher for Medicare patients: Medicare payments for the six months after a hip fracture alone average $23,500. Of that sum, $3,800 is for treatment in a skilled nursing facility. Every year, falls among older people cost the United States more than $20.2 billion. By 2020, the total annual cost of these injuries is expected to reach $32.4 billion.

Older adults with osteoporosis, a disease characterized by low bone mass and deteriorating bone tissue, are particularly at risk for a hip fracture, Stevens said. Because women generally have bones that are less dense than those of men, hospitalization rates for hip fractures among women are triple those of men.

The Medicare Osteoporosis Measurement Act of 2001 expands Medicare cov, erage of bone mass measurements to all Americans at clinical risk for osteoporosis. This new law enables people at high risk to be screened and treated for low bone density before their increasing bone fragility results in a fracture.

Although it may be too late for an older person to build up bone mass, there are many ways to help prevent falls at any age. Especially important are educating long-term care staff about risk factors for falls; monitoring medication use; and making environmental changes, such as clearing pathways and lowering beds. Simple changes to an older person's home, such as removing throw rugs and adding grab bars to bathrooms, can quickly and easily reduce the risk of falling. Since vision problems can increase a person's risk for falls by as much as 60%, correcting vision and improving lighting in the home are effective strategies for preventing falls.

Other ways to prevent falls aren't as obvious or immediate. Tai chi or weight-- resistance exercise, for example, can reduce elders' risk for falls by helping them maintain and improve their balance, strength and coordination. CDC has developed the report National Blueprint: Increasing Physical Activity Among Adults Age 50 and Older to promote physical activity among older adults.

Medication reviews are another important method of reducing an older person's risk of falling, Stevens added. Because of their higher rates of chronic health problems, older adults often take medications whose side effects-such as drowsiness and dizziness-potentially can lead to a fall, particularly when there are multiple drug interactions. …

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