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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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Presentation Transcript
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

slide3
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

trends in age adjusted nonfatal fall rates men women 65 2001 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
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
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
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
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

slide13
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)

effective fall prevention strategies1
Review & manage medicationsEffective Fall Prevention Strategies

___________

Cumming RG, Drugs & Aging, 1998

Ray W, Topics in Geriatric Rehab, 1990

effective fall prevention strategies2
Effective Fall Prevention Strategies
  • Maximize vision
  • ___________
  • Lord SR, JAGS 2001
effective fall prevention strategies3
Effective Fall Prevention Strategies
  • Improve home safety

___________

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

slide19

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)

slide20

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
slide21

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
slide22

Injury Prevention

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