Older Adult Falls: Effective Approaches to Prevention
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The issue of older adult falls combines a problem with high incidence and high injury susceptibility with an increasing population at risk. A firm understanding of both fall risk factors and effective strategies is required to reduce risk and prevent these injuries.
Each year, 28.7% of older adults aged ≥65 sustain a fall. At the national level, this represents 29 million falls resulting in 27,000 deaths and 7 million injuries requiring medical treatment or restricted activity for at least 1 day. There are several strategies that have been shown to effectively reduce the risk or the incidence of falls.
More than 90% of older adults see a medical provider at least once a year providing an opportunity to identify and address fall risk factors. Comprehensive fall prevention in the primary care setting is both feasible and practical.
KeywordsSenior falls Fall prevention Effective fall prevention Clinician role fall prevention
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Conflict of Interest
Dr. Dellinger declares no conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the author.
The findings and conclusions in this report are those of the author and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 1.Pew Research Center. Available at: www.pewresearch.org.
- 2.Centers for Disease Control and Prevention. Older adult falls. Available at: https://www.cdc.gov/homeandrecreationalsafety/falls/index.html.
- 3.• Bergen G, Stevens MR, Burns ER. Falls and fall injuries among adults aged >65 years—United States, 2014. MMWR. 2016;65(37):993–8. This article provides national estimates of the self-reported incidence of older adult falls and the proportion injured by state. Google Scholar
- 4.• Burns ER, Stevens JA, Lee R. The direct costs of fatal and non-fatal falls among older adults—United States. J Saf Res. 2016; doi: 10.1016/j.jsr.2016.05.001. This article provides national estimates of direct medical costs for older adult falls in hospital, emergency department, and outpatient settings.
- 5.Stockdale H, Guillory K. In American Cancer Society Cancer Action Network (Ed.), Why cancer patients depend on Medicare for critical coverage Available at: www.acscsn.org/content/wp-content/uploads/2013/06/2013-Medicare-Chartbook-Online-Version.pdf.
- 6.• Dieleman JL, Baral R, Birger M, Bui AL, Bulchis A, Chapin A, et al. US spending on personal health care and public health, 1996–2013. JAMA. 2016;316(24):2627–46. doi: 10.1001/jama.2016.16885. This article provides estimates of US healthcare spending for 155 conditions.
- 7.Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based injury statistics query and reporting system (WISQARS) [online]. (2005). Available at: www.cdc.gov/injury/wisqars(https://www.cdc.gov/injury/wisqars).
- 8.McMahon S, Talley KM, Wyman JF. Practice development section paper 1 older people’s perspectives on fall risk and fall prevention programs: a literature review. Int J Older People Nursing. 2011;6(4):289–98. doi: 10.1111/j.1748-3743.2011.00299.x. https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=22078019.CrossRefGoogle Scholar
- 22.American Geriatrics Society, British Geriatrics Society, American Academy of Orthopaedic Surgeons Panel on Falls Prevention. Guideline for the prevention of falls in older persons. Special series: clinical practices. J Am Geriatr Soc. 2001;49:664–72.Google Scholar
- 23.•• Panel on Prevention of Falls in Older Persons, American Geriatrics Society, British Geriatrics Society. Summary of the updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc. 2011;59:148–57. This is an updated summary of the practice guideline for older adult fall prevention that provides graded recommendations for care. Google Scholar
- 28.Thomas S, Mackintosh S, Halbert J. Does the Otago exercise programme reduce mortality and falls in older adults?: a systematic review and meta-analysis. Age Ageing. 2010;39(6):681–687. doi: 10.1093/ageing/afq102.
- 31.• Stevens JA, Burns ER. A CDC compendium of effective fall interventions: what works for community-dwelling older adults. 3rd ed. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, 2015. This report showcases effective single and multifactorial interventions in the areas of exercise, home modification, and clinical strategies that include vitamin D supplementation, medication modification, vision correction, podiatry, and pacemaker surgery. Google Scholar
- 34.Li F, Harmer P, Fisher KJ, McAuley E, Chaumeton N, Eckstrom, et al. Tai Chi and fall reductions in older adults: a randomized controlled trial. J Gerontology. 2005;60A(2):187–94.Google Scholar
- 38.Institute of Medicine, Committee to Review Dietary Reference Intakes for Vitamin D and Calcium, Dietary intakes; calcium and vitamin D, 2011. Available at: www.ncbi.nlm.nih.gov/books/NBK56070.
- 40.Looker AC, Johnson CL, Lacher DA, Pfeiffer CM, Schleicher RL, Sempos T. Vitamin D status: United States, 2001–2006. National Center for Health Statistics Data Brief No 59. 2011. Available at: https://www.cdc.gov/nchs/data/databriefs/db59.pdf.
- 42.Spink MJ, Menz HB, Fotoohabadi MR, Wee E, Landorf KB, Hill KD, et al. Effectiveness of a multifaceted podiatry intervention to prevent falls in community dwelling older people with disabling foot pain: randomized controlled trial. BMJ. 2011;342:d3411. doi: 10.1136/bmj.d3411.CrossRefPubMedPubMedCentralGoogle Scholar
- 51.O’Hara B, Caswell K. Health Status, health insurance, and medical services utilization: 2010. P70-133RV, Current Population Reports, U.S. Census Bureau, Washington, DC, 2013.Google Scholar
- 58.Phelan EA, Aerts S, Dowler D, Eckstrom E, Casey CM. Adoption of evidence-based fall prevention practices in primary care for older adults with a history of falls. Front Public Health. 2016;4:190. doi: 10.3389/fpubh.2016.00190.
- 61.• Casey CM, Parker EM, Winkler G, Liu X, Lambert GH, Eckstrom E. (2016) Lessons learned from implementing CDC’s STEADI falls prevention algorithm in primary care. Gerontologist. doi: 10.1093/geront/gnw074. This article provides a real-world example of how to incorporate older adult fall prevention into a fast-paced primary care setting.