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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Introduction
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
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
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
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
Nonfatal Fall Injury Rates by Sex & Age, People 65+, 2006U.S., 2007

Women

Men

__________

NEISS-AIP, 2007


Trends in age adjusted nonfatal fall rates men women 65 2001 2007
Trends in People 65+, 2006Age-Adjusted Nonfatal Fall Rates Men & Women 65+, 2001-2007

Women

6%

Men

8%

_________

NEISS-AIP 2001-2007


Where do falls happen
Where People 65+, 2006 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
Why People 65+, 2006 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
Economic Impact People 65+, 2006

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
Quality of Life People 65+, 2006

  • 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 People 65+, 2006

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)


Effective fall prevention strategies

Exercise for balance & strength People 65+, 2006

Effective Fall Prevention Strategies

  • ___________

  • Lord SR, JAGS, 2003


Effective fall prevention strategies1

Review & manage medications People 65+, 2006

Effective Fall Prevention Strategies

___________

Cumming RG, Drugs & Aging, 1998

Ray W, Topics in Geriatric Rehab, 1990


Effective fall prevention strategies2
Effective Fall Prevention Strategies People 65+, 2006

  • Maximize vision

  • ___________

  • Lord SR, JAGS 2001


Effective fall prevention strategies3
Effective Fall Prevention Strategies People 65+, 2006

  • Improve home safety

___________

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


Older Adult Fall Prevention People 65+, 2006


Fall Prevention Interventions People 65+, 2006

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 People 65+, 2006

  • 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 People 65+, 2006

  • 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 People 65+, 2006

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


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