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Unintentional Injury.

Falls and Hip Fractures Among the Elderly Fact Sheet

How extensive is the problem of falls among elderly people?

It is a serious public health problem. Each year, in the United States, one of every three people older than age 65 falls.[1,2]

How many elderly people die as a result of a fall?

In 1995, more than 7,700 people over age 65 years died as a result of falls.(3) For people aged 65-84 years, falls are the second leading cause of injury-related death; for those aged 85 years or older, falls are the leading cause of injury-related death.[3] Of all deaths associated with falls, 60% involve people aged 75 years or older.[3]

What are some other health-related consequences of falls among the elderly?

Falls are the most common cause of injuries and hospital admissions for trauma among the elderly. Falls account for 87% of all fractures among people aged 65 years or older4 and are the second leading cause of spinal cord and brain injury.[5] Each year in the United States, one person in 20 receives emergency department treatment because of a fall.[6] Advance, d age substantially increases a person=s likelihood of hospitalization after a fall. For the elderly, fractures are the most serious consequence of falls and happen to 5% of all people who fall. The most common fractures from falls are of the pelvis, hip, femur, vertebrae, humerus, hand, forearm, leg, and ankle.[7] Of these, hip fractures are the most serious.

Which type of fracture creates the most health problems for elderly people?

Of all fractures from falls, hip fractures cause the greatest health problems and the greatest number of deaths. About 240,000 hip fractures occur each year among people older than 50 years.[8] Half of all elderly adults hospitalized for hip fracture cannot return home or live independently after the fracture.[7,9] People older than 85 years are 10 to 15 times more likely to experience a hip fracture than are people aged 60 to 65 years.[7]

How much do hip fractures cost? How long are people hospitalized for hip fracture?

Most patients with hip fractures are hospitalized for about 2 weeks. A 1986 study estimated that hip fractures accounted for over $3 billion in direct medical costs,[l0]

What factors increase elderly people=s risk of falling?

Among the elderly, factors that contribute to falls include dementia, visual impairment, neurologic and musculoskeletal disabilities, psychoactive medications, and difficulties in gait and balance.[11,12] Environmental hazards such as slippery surfaces, uneven floors, poor lighting, loose rugs, unstable furniture, and objects on floors may also play a role.[1]

Where are elderly people likely to fall?

For people aged 65 years or older, 60% of fatal falls occur in the home, 30% occur in public places, and 10% occur in health care institutions.[12]

What are some strategies for preventing elderly people from falling?

Physical activity to improve strength, mobility and flexibility.[13,14] Adequate medical supervision to minimize use of psychoactive medication and maximize control of medical conditions.[15] Environmental modifications such as installing grab bars and removing tripping hazards (e.g., loose rugs).[16]

What research or programs does CDC support which focus on fall-related injuries?

A project with the Southern California Injury Prevention Research Center (SCIPRC), at the University of California at Los Angeles, to prevent falls and fall-related injuries among elderly Hispanics living in East L.A.

A collaboration with the National Fire Protection Association (NFPA), Consumer Product Safety Commission (CPSC), United States Fire Administration, National SAFE KIDS Campaign, Indian Health Service, Administration on Aging, and Head Start to reduce injury from falls and fires in the states of Mississippi, Arkansas and Alaska, and the cities are Atlanta and Cleveland.

A research project at Vanderbilt University comparing two different types of antidepressants among approximately 5,000 nursing home residents to determine whether either or both types of medications increase the risk of hip fractures.

An analysis of survival rates among postmenopausal women from the Group Health Collaborative in Seattle, Washington, who have sustained hip fractures. The study will compare survival among women who have and have not used hormone replacement therapy.

References

[1.] Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med1989;320(16):1055-9.

[2.] Sattin RW. Falls among older persons: A public health perspective. Annu Rev Public Health 1992;13:489-508.

[3.] NCIPC. National Summary of Injury Mortality Data, 1988-1994. Atlanta (GA): Centers for Disease Control and Prevention, 1996.

[4.] Fife D, Barancik JI. Northeastern Ohio Trauma Study III: Incidence of fractures. Ann Emerg Med 1985; 14:244-8.

[5.] Kraus KF, Black MA, Hessol N et al. The incidence of acute brain injury and serious impairment in a defined population. Am J Epidemiol 1984;119:186-201.

[6.] Barancik JI, Chatterjee BF, Greene YC, et al. Northeastern Ohio Trauma Study: I. Magnitude of the problem. Am J Public Health 1983;73:746-51.

[7.] Melton LJ III, Riggs BL. Epidemiology of age-related fractures. In: Avioli LV, editor. The osteoporotic syndrome. New York: Grune & Stratton; 1983. p. 45-72.

[8.] Cummings SR, Rubin SM, Black D. The future of hip fractures in the Unites States. Numbers, costs, and potential effects of postmenopausal estrogen. Clin Orthop 1990;252:163-6.

[9.] Scott JC. Osteoporosis and hip fractures. Rheum Dis Clin North Am 1990;16(3):717-40.

[10.] Norris RJ. Medical costs of osteoporosis. Bone 1992; 13:S11-6.

[11.] Tinetti ME, Speechley M. Prevention of falls among the elderly. N Eng1 J Med 1989;320(16):1055-9.

[12.] Sorock GS. Falls among the elderly: epidemiology and prevention. Am J Prev Med1988;4(5):282-8.

[13.] Judge JO, Lindsey C, Underwood M, et al. Balance improvements in older women: effects of exercise training. Phys Ther 1993;73(4):254-62, 263-5.

[14.] Lord SR, Caplan GA, Ward JA. Balance, reaction time, and muscle strength in exercising older women: a pilot study. Arch Phys Med Rehabil 1993;74(8):837-9.

[15.] Ray W, Griffin MR. Prescribed medications and the risk of falling. Top Geriatr Rehabil 1990;5:12-20.

[16.] Tideiksaar R. Preventing falls: home hazard checklists to help older patients protect themselves. Geriatrics 1986;41(5):26-8.

For more information, write or call 770.488.4652 National Center for Injury Prevention and Control Division of Unintentional Injury Prevention Mailstop K60 4770 Buford Highway NE Atlanta, GA 30341-3724

Please send questions and comments to DUIPINFO@cdc.gov

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04.20.98
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Date:Apr 20, 1998
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