Falls a common concern of seniors
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We offer a complimentary fall-risk and/or home safety assessments to our managed care seniors.  Please call our Wellness Center at 760-969-6550. Falls A Common Concern of Seniors. Falls: A Common Concern of Seniors. More than 1/3rd of adults 65+ fall each year in US

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Falls A Common Concern of Seniors

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We offer a complimentary fall-risk and/or home safety assessments to our managed care seniors.  Please call our Wellness Center at 760-969-6550.

FallsA Common Concern of Seniors


Falls: A Common Concern of Seniors

  • More than 1/3rd of adults 65+ fall each year in US

  • 50% of seniors that fall have fallen before

  • As the Senior population increases,

    so will the absolute number of falls


Population Growth


By Age Per Year

65- 69 22.4%

70- 74 27.9%

75- 79 31.4%

80- 84 39.6%

Who Falls?


Who Falls?

  • Women 65+ 30%

  • Men 65+ 13%

  • Gender Differences decrease after 75; at 85 Men = Women

By Sex


Community: 0.2 - 0.8 per person per year

Hospital: 0.6 - 2.9 per person per year

Long-term Care: 0.6 - 3.6

Who Falls?

By Living Environment (rates)


Fear of falling

Falls cause


Falls cause:

  • Fear of falling

  • limits activities

  • leads to decreased mobility/fitness

    - increases social isolation

    - increases actual risk of falling


Fear of falling

Increased risk of Nursing Home Placement

Falls cause


Falls cause

  • Increased risk of Nursing Home Placement

    - those 75+ who fall are 4-5x more likely to be admitted to long-term care for 1 + years


Fear of falling

Increased risk of Nursing Home Placement

Moderate to severe injuries

Falls cause


Moderate to severe injuries

- bruises,

- traumatic brain injuries

- accounts for 46% of fatal falls

- fractures: 6% of falls, including, spine, hip, leg, pelvis, ankle upper arm and hand

Falls cause


Fear of falling

Increased risk of Nursing Home Placement

Moderate to severe injuries

Increased risk of death

Falls cause


Falls cause

  • Increased risk of death

    - 15,800 annual deaths in seniors d/t fall (2005);

    1.8 Million treated in ER

  • 85% percent of deaths from falls from seniors 75

    and older

  • after 75 years, white men have highest fatality rates > white women > black men > black women

    - Men are more likely to die than women (49% higher mortality rates)


Hip Fractures in Seniors

  • 1% of falls result in hip fractures

    ($10 billion cost)

  • 350,000 senior hip fractures/year

  • 60% have restricted mobility

  • 25% remain functionally more dependent

  • 25% die within 1 year


Reasons Why Falls Occur

Intrinsic FactorsExtrinsic Factors

Normal Aging Changes

FALLS


Normal Aging Changes

Neurologic

- proprioception

reaction time

righting reflexes

Intrinsic Factors


Normal Aging Changes

Neurologic

Gait

- Slower

- Stride length and arm swing

- Body flexion & head/torso; knees shoulders forward

- Lateral sway

Intrinsic Factors


Normal Aging Changes

Neurologic

Gait

Vision

Accommodation

Dark adaptation

Intrinsic Factors


Normal Aging Changes

Neurologic

Gait

Vision

Muscle mass

Intrinsic Factors


Reasons Why Falls Occur

Intrinsic FactorsExtrinsic Factors

Normal Aging Changes

Chronic & Acute Disease

FALLS


Intrinsic Factors

Chronic Disease

  • Cataracts, macular degeneration

  • Arthritis

  • Parkinsons, Strokes

  • The “Dizzy’s”


Chronic Disease

The “Dizzy’s”

27% of seniors 65+ report during last month

37% last > 1 minute

50% of those 80 or greater that are dizzy due to Benign Positional Vertigo

Usually due to many causes:

- Meniere's disease, circulation, blood pressure drops,

- anemia, heart rhythms, anxiety/depression

Intrinsic Factors


Intrinsic Factors

Acute Illness/Confusion

  • UTI, pneumonia, diarrhea, dehydration, vomiting


Reasons Why Falls Occur

Intrinsic FactorsExtrinsic Factors

Normal Aging Changes

Chronic & Acute Disease

Trouble walking

FALLS


Trouble Walking (Dysmobility)

- Trouble walking increases with age

- > 65 y/o: 15%

- 85 y/o: 25% men; 33% women

- 2/3 of seniors in hospital/Nursing Homes

can’t walk w/o assistance

Intrinsic Factors


Reasons Why Falls Occur

Intrinsic FactorsExtrinsic Factors

Normal Aging Changes

Chronic & Acute Disease

Medications

FALLS


4+ prescriptions!

Extrinsic Factors


Medications

The big offenders

- Sedative/hypnotics

Depression/anxiety/mood-stabilizing medications

- Heart, blood pressure, seizure, incontinence, other medications

Extrinsic Factors


Reasons Why Falls Occur

Intrinsic FactorsExtrinsic Factors

Normal Aging Changes

Chronic & Acute Disease

Medications

Environment

Improper Use of Cane/Walker

FALLS


Environment

- Home hazards: bathrooms, stairs, clutter,

throw rugs, lighting, sidewalks

- "risky" behavior

Improper use of cane/walker

Extrinsic Factors


So What to Do?

Falls: A Common Concern of Seniors


Screen for Risk Factors

Do your own Home Safety Evaluation

Evaluate your activity; Exercise

Talk to your doctor

So What to Do?


Nintendo Wii Golf

So What to Do?


What your doctor will be thinking

Join exercise program

None

Ask all >= 75+

1 Fall or Balance/ Gait

>= 2 Falls or Balance/ Gait

Dx & Treat


Specific Risk Factors, Assessment, Management


Specific Risk Factors, Assessment, Management


Specific Risk Factors, Assessment, Management


Evidence shows these interventions work!


Evidence shows these interventions work!


FallsA Common Concern of Seniors

We offer a complimentary fall-risk and/or home safety assessments to our managed care seniors.  Please call our Wellness Center at 760-969-6550.


References

Center for Disease Control and Prevention, National Center for Health Statistics,

Health, United States, 2007.

“Clinical Practice”. New England Journal of Medicine 2 January 2003:41-44.

“What Causes Falls in the Elderly.” American Family Physician. 1 Apr. 2000. http://www.aafp.org/online/en/home.html


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