Older Adult Falls from a National Perspective
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Transcript of Older Adult Falls from a National Perspective
Department of Health and Human Services, Centers for Disease Control and Prevention
Older Adult Falls from a National Perspective
Judy A. Stevens, Ph.D.Division of Unintentional Injury Prevention
National Center for Injury Prevention & Control
ASTHO/NACCHO TeleconferenceMay 25, 2004
Department of Health and Human Services, Centers for Disease Control and Prevention
Overview
Background & Impact Epidemiology Fall risk factors Prevention strategies Current activities Resources
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Projected Growth in Older U.S. Population
0
100
200
300
400
500
2000 2010 2020 2030 2040
Year
Po
pu
lati
on
(m
illi
on
s)
34.839.7 53.7 70.3
77.2
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Leading Causes of Unintentional Injury Death Among People 65+, 2001
Unspecified18%
Suffocation10%
Poisoning2%
Other7%
Drowning1%
Fire/Burn4%
Falls35%
M.V.23%
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NCHS, Vital Records, 2001
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Falls
35%-40% 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
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1. Hornbrook, Gerontologist, 1994; Hausdorff, Arch Phys Med & Rehab, 2001 2. Tinetti, New Eng J Med, 1988; Teno, JAGS,19903. Sterling, J Trauma-Inj Infection & Critical Care, 2001
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Data Sources
Fatal falls – NCHS death certificate data
Nonfatal injuries – NEISS-AIP
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Fatal & Nonfatal Fall Injuries Among People Age 65+, 2001
11,600
373,000
1,260,000
? Millions
1% - Died
23% - Treated in ED & Hospitalized
76% - Treated in ED & released
Fall-related injuries
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Nonfatal falls: NEISS-AIP, 2001Fall deaths: NCHS, Vital Records, 2001
{ 1.6 million
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Impact
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Financial Cost (current dollars)
In 1994, total cost of fall injuries among people 65+ $27.3 billion1
Medicare costs for hip fractures$4.7 billion in 19912
$240 billion projected for 20403
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1. Englander F, J Forensic Science, 1996 2. CDC, MMWR, 1996 3. Cummings SR, Orthopaedics & Related Res,1990
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Quality of Life
20% - 30% fear falling1
20% die within a year afterhip fracture2 25% in a nursing home one year later3
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1. Vellas BJ, Age & Aging, 1997; Friedman SM, JAGS, 2002 2. Lu-Yao GL, AJPH, 19943. Magaziner, J Gerontology: Medical Sciences, 2000
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Fall Death Rates for Men & Women 65+ by Age Groups, 2001
0
25
50
75
100
125
150
175
65-69 70-74 75-79 80-84 85+
Age groups
Per
100,0
00
Women
Men
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NCHS, Vital Records, 2001
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Trends in Age Adjusted Fall Death Rates Men & Women 65+, 1990-2001
0
5
10
15
20
25
30
35
40
Year
Per
100,0
00
Men
Women
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NCHS, Vital Records, 2001
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Leading Causes of Nonfatal Unintentional Injuries Among People 65+
Struck by/Against7%
MV Occupant7%
Overexertion6%
Cut/pierce5%
Other transport2%
Foreign body1%
Unknown2%
Bite/sting2%
Poisoning1%
Falls63%
All others4%
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NEISS-AIP, 2001
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Nonfatal Fall Injury Rates for Men & Women 65+ by Age Group, 2001
0
2500
5000
7500
10000
12500
15000
65-69 70-74 75-79 80-84 85+
Age groups
Per
100,0
00
Women
Men
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NEISS-AIP, 2001
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Hip Fractures
95% of hip fractures caused by falls 2000 - 321,000 hospital admissions
76% were women 40% were age 85+
Rates increase with age Rates higher among women
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Nyberg, JAGS, 1996 NCHS, National Hospital Discharge Survey, 2000
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Risk Factors for Falls
Personal Environmental
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Personal Risk Factors
Older age Female Chronic diseases Mental impairment
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Personal Risk Factors (modifiable)
Muscle weakness 4.4 x Gait & balance problems 2.9 x Vision problems 2.5 x Psychoactive medications 1.7 x
Relative Risk
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American Geriatrics Society, JAGS, 2001
Department of Health and Human Services, Centers for Disease Control and Prevention
Environmental Factors (modifiable)
Clutter in walkways No stair railings or
grab bars Loose rugs Dim lighting
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Interventions – What Works? Comprehensive clinical
assessment1
Exercise for balance & strength2
Medication management3 Vision correction4
Reducing home hazards5
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1. American Geriatrics Society, JAGS, 2001 2. Lord SR, JAGS, 2001 3. Cumming RG, Drugs & Aging, 1998 4. Ray W, Topics in Geriatric R Rehab,1990 5. Day L, BMJ 2002; Gill TM, JAGS, 1999
Department of Health and Human Services, Centers for Disease Control and Prevention
Current Activities
Cooperative Agreements California Michigan Washington State Wisconsin
Extramural Grants North Carolina - UNC Tennessee - Vanderbilt
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Resources for Fall Prevention Programs
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National Resource Center for Safe Aging
• San Diego State University • Collect, organize, disseminate injury
prevention information• Serve public health professionals &
aging service providers
www.safeaging.org (being updated)
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Publication No. NIH 99-4258www.nih.gov/nia
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www.cdc.gov/injury
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WISQARSTM (Web-based Injury Statistics Query and Reporting System)
• An interactive database system
• Provides customized reports of fatal & nonfatal injury data
www.cdc.gov/ncipc/wisqars/default.htm
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Tool Kit to Prevent Senior Falls
Fall prevention brochure Home safety checklist Fact sheets & graphs Summary of research
www.cdc.gov/ncipc/pub-res/toolkit/toolkit.htm
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US Fall Prevention Programs for Seniors
18 comprehensive programs in 12 states
Program descriptions & contact information
Contact information for 22 additional programs
www.cdc.gov/ncipc/falls/default.htm
Department of Health and Human Services, Centers for Disease Control and Prevention