Falls Among Older Adults: An Overview
Older Adult Falls

10 aug 2008--How big is the problem?
More than one third of adults 65 and older fall each year in the United States (Hornbrook et al. 1994; Hausdorff et al. 2001).
Among older adults, falls are the leading cause of injury deaths. They are also the most common cause of nonfatal injuries and hospital admissions for trauma (CDC 2006).
In 2005, 15,800 people 65 and older died from injuries related to unintentional falls; about 1.8 million people 65 and older were treated in emergency departments for nonfatal injuries from falls, and more than 433,000 of these patients were hospitalized (CDC 2008).
The rates of fall-related deaths among older adults rose significantly over the past decade (Stevens 2006).
What outcomes are linked to falls?
Twenty percent to 30% of people who fall suffer moderate to severe injuries such as bruises, hip fractures, or head traumas. These injuries can make it hard to get around and limit independent living. They also can increase the risk of early death (Alexander et al. 1992; Sterling et al. 2001).
Falls are the most common cause of traumatic brain injuries, or TBI (Jager et al. 2000). In 2000, TBI accounted for 46% of fatal falls among older adults (Stevens et al. 2006).
Most fractures among older adults are caused by falls (Bell et al. 2000).
The most common fractures are of the spine, hip, forearm, leg, ankle, pelvis, upper arm, and hand (Scott 1990).
Many people who fall, even those who are not injured, develop a fear of falling. This fear may cause them to limit their activities, leading to reduced mobility and physical fitness, and increasing their actual risk of falling (Vellas et al. 1997).
In 2000, direct medical costs totaled $0.2 billion ($179 million) for fatal falls and $19 billion for nonfatal fall injuries (Stevens et al. 2006).
Who is at risk?
Men are more likely to die from a fall. After adjusting for age, the fall fatality rate in 2004 was 49% higher for men than for women (CDC 2005).
Women are 67% more likely than men to have a nonfatal fall injury (CDC 2006).
Rates of fall-related fractures among older adults are more than twice as high for women as for men (Stevens et al. 2005).
In 2003, about 72% of older adults admitted to the hospital for hip fractures were women (CDC 2005).
The risk of being seriously injured in a fall increases with age. In 2001, the rates of fall injuries for adults 85 and older were four to five times that of adults 65 to 74 (Stevens et al. 2005)
Nearly 85% of deaths from falls in 2004 were among people 75 and older (CDC 2006).
People 75 and older who fall are four to five times more likely to be admitted to a long-term care facility for a year or longer (Donald et al. 1999).
There is little difference in fatal fall rates between whites and blacks from ages 65 to 74 (CDC 2006).
After age 75, white men have the highest fatality rates, followed by white women, black men, and black women (CDC 2006).
White women have significantly higher rates of fall-related hip fractures than black women (Stevens 2005).
Among older adults, non-Hispanics have higher fatal fall rates than Hispanics (Stevens et al. 2002).

How can older adults prevent falls?Older adults can take several steps to protect their independence and reduce their risk of falling. They can:
Exercise regularly; exercise programs like Tai Chi that increase strength and improve balance are especially good.
Ask their doctor or pharmacist to review their medicinesboth prescription and over-the counterto reduce side effects and interactions.
Have their eyes checked by an eye doctor at least once a year.
Improve the lighting in their home.
Reduce hazards in their home that can lead to falls.

What is CDC doing to prevent falls among older adults?
CDC supports research and dissemination on ways to help prevent falls among older adults. To read about these activities, follow the link to CDC Fall Prevention Activities.
CDC has also developed brochures and posters, in partnership with the CDC Foundation and MetLife Foundation, to educate older adults and those who care for them about preventing falls and the injuries that result.
References
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Bell AJ, Talbot-Stern JK, Hennessy A. Characteristics and outcomes of older patients presenting to the emergency department after a fall: a retrospective analysis. Medical Journal of Australia 2000;173(4):1767.
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) [online]. (2006) [cited 2007 Jan 15]. Available from URL: www.cdc.gov/ncipc/wisqars.
Donald IP, Bulpitt CJ. The prognosis of falls in elderly people living at home. Age and Ageing 1999;28:1215.
Hausdorff JM, Rios DA, Edelber HK. Gait variability and fall risk in community-living older adults: a 1-year prospective study. Archives of Physical Medicine and Rehabilitation 2001;82(8):10506.
Hornbrook MC, Stevens VJ, Wingfield DJ, Hollis JF, Greenlick MR, Ory MG. Preventing falls among community-dwelling older persons: results from a randomized trial. The Gerontologist 1994:34(1):1623.
Jager TE, Weiss HB, Coben JH, Pepe PE. Traumatic brain injuries evaluated in U.S. emergency departments, 19921994. Academic Emergency Medicine 2000;7(2):13440.
Scott JC. Osteoporosis and hip fractures. Rheumatic Diseases Clinics of North America 1990; 16(3): 717-40.
Sterling DA, O'Connor JA, Bonadies J. Geriatric falls: injury severity is high and disproportionate to mechanism. Journal of Trauma-Injury, Infection and Critical Care 2001;50(1):1169.
Stevens JA. Falls among older adultsrisk factors and prevention strategies. NCOA Falls Free: Promoting a National Falls Prevention Action Plan. Research Review Papers. Washington (DC): The National Council on the Aging; 2005.
Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of fatal and nonfatal falls among older adults. Injury Prevention 2006;12:2905.
Stevens JA, Dellinger AM. Motor vehicle and fall related deaths among older Americans 199098: sex, race, and ethnic disparities. Injury Prevention 2002;8:2725.
Stevens JA, Sogolow ED. Gender differences for non-fatal unintentional fall related injuries among older adults. Injury Prevention 2005;11:1159.
Stevens JA. Fatalities and injuries from falls among older adults  United States, 19932003 and 20012005. MMWR 2006;55(45).
Vellas BJ, Wayne SJ, Romero LJ, Baumgartner RN, Garry PJ. Fear of falling and restriction of mobility in elderly fallers. Age and Ageing 1997;26:189193.