Older Adult Falls Prevention
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Older Adult Falls Prevention. Angela Marr, MPH. Introduction. 30-35% of people 65+ fall each year 1 Those who fall are 2-3 times more likely to fall again 2 10%-20% of falls cause serious injuries 3. __________ 1. Hornbrook, Gerontologist, 1994; Hausdorff, Arch Phys Med & Rehab, 2001

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Angela Marr, MPH

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Older Adult Falls Prevention

Angela Marr, MPH


Introduction

  • 30-35% of people 65+ fall each year1

  • Those who fall are 2-3 times more likely to fall again2

  • 10%-20% of falls cause serious injuries3

__________

1. Hornbrook, Gerontologist, 1994; Hausdorff, Arch Phys Med & Rehab,2001

2. Tinetti, New Eng J Med,1988; Teno, JAGS,1990

3. Sterling, J Trauma-Inj Infection & Critical Care,2001


If an older adult falls, 2-3 times more likely to fall again

Fall and Nonfatal Fall

Injuries Among People 65+--2006

14,903

Died

432,629

Hospitalized

1,309,722

Treated & released

?Millions

(Oliver, 2009), (Arias, 2008)


Fall Death Rates by Sex & Age, 2006

Men

Women

__________

NCHS, Vital Records, 2006


Trends in Age-Adjusted Fall Death Rates Men & Women 65+, 2000-2006

Men

35%

Women

45%

___________

NCHS, Vital Records, 2006


Leading Causes of Nonfatal Unintentional Injuries Among People 65+, 2006

Total = 3.1 million injuries

N=1.84 million

__________

NEISS-AIP, 2006


Nonfatal Fall Injury Rates by Sex & Age, U.S., 2007

Women

Men

__________

NEISS-AIP, 2007


Trends in Age-Adjusted Nonfatal Fall Rates Men & Women 65+, 2001-2007

Women

6%

Men

8%

_________

NEISS-AIP 2001-2007


Where Do Falls Happen?

  • At home, outside…….......35%

  • At home, inside…………..23%

  • Away from home, in a

    familiar place……………..23%

  • Away from home, in an

    unfamiliar place…………..19%

______

Berg WP, Age & Ageing, 1997


Why Do Falls Happen?

  • Slipped or tripped….….59%

  • Misplaced step…….…..12%

  • Loss of balance……….. 9%

  • Legs give way ….….….. 4%

  • Other……………………16%

______

Berg WP, Age & Ageing, 1997


Economic Impact

In 2000, cost of fatal fall injuries among people 65+:

Total: ~$19 billion

  • Fatal falls: $0.2 billion

  • Nonfatal injuries: $19 billion

  • ___________

  • Stevens JA, Inj Prev, 2006


Quality of Life

  • 20% - 36% fear falling1

  • 20% die within a year after hip fracture2

  • 25% in a nursing home one year later3

___________

1. Vellas BJ, Age & Aging, 1997; Friedman SM, JAGS, 2002

2. Lu-Yao GL, AJPH, 1994

3. Magaziner, J Gerontology: Medical Sciences, 2000


Biological Risk Factors

Poor control and prevention of chronic health problems

Mobility Problems due to muscle weakness or balance

Vision changes or vision loss

Behavioral Risk Factors

Medication side effects and interactions

Inactivity (physical, mental, social)

Alcohol use

Environmental Risk Factors

Home and environmental hazards

Poorly designed public spaces

Incorrect use of assistive devices

Fall Risk Factors

Preventing Falls: How to Develop Community-based Fall Prevention Programs for Older Adults (CDC, 2008)


Exercise for balance & strength

Effective Fall Prevention Strategies

  • ___________

  • Lord SR, JAGS, 2003


Review & manage medications

Effective Fall Prevention Strategies

___________

Cumming RG, Drugs & Aging, 1998

Ray W, Topics in Geriatric Rehab, 1990


Effective Fall Prevention Strategies

  • Maximize vision

  • ___________

  • Lord SR, JAGS 2001


Effective Fall Prevention Strategies

  • Improve home safety

___________

Day L, BMJ 2002; Gill TM, APHA, 1999


Older Adult Fall Prevention


Fall Prevention Interventions

Preventing Falls: What Works A CDC Compendium of Effective Community-based Interventions from Around the World (CDC, 2008), (Carande-Kulis et.al, 2010)


Discussion: Tai Chi Moving for Better Balance

  • Exercise Based Intervention

    • Addresses biological risk factors

      • Promotes strengthening of muscles and improved balance

      • Control chronic health conditions through exercise

    • Addresses behavioral risk factors

      • Promotes physical, mental and social activity


Discussion: Stepping On

  • Multifaceted Intervention

    • Addresses biological risk factors

      • Strength and balance exercises

      • Nutrition education

      • Poor vision assessment

    • Addresses behavioral risk factors

      • Medication management

      • Promotes physical, mental, and social activity

    • Addresses environmental risk factors

      • Assessment of hazards in and around the home

      • Assist with home adaptations and modifications


Injury Prevention

When It Comes ToInjury Prevention,We’re DoingMore Than JustCrossing Our Fingers.


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