Falling

The Cost of Falling

In 2012, the direct medical costs of older adult falls, adjusted for inflation, were $30 billion (Stevens, Corso, Finkelstein & Miller, 2006). With the population aging, both the number of falls and the costs to treat fall injuries are likely to increase.

 How big of a problem are falls?

One in three adults aged 65 and older falls each year (Tromp, Pluijm & Smit, 2001).  Of those who fall, 20% to 30% suffer moderate to severe injuries that make it hard for them to get around or live independently, and increase their risk of early death (Sterling, O’Connor & Bonadies, 2001).

Older adults are hospitalized for fall-related injuries five times more often than they are for injuries from other causes (Alexander, Rivara, & Wolf, 2001).

In 2012, emergency departments treated 2.4 million nonfatal fall injuries among older adults; more than 722,000 of these patients had to be hospitalized (CDC, 2010).

Fall-related injuries are more common among older persons and are a major cause of pain, disability, loss of independence and premature death. Approximately 28-35% of people aged of 65 and over fall each year increasing to 32-42% for those over 70 years of age. The financial costs are substantial and increasing worldwide. The average health system cost per one fall injury episode for people 65 year and older in Finland and Australia was US$ 3611 (WHO, 2012).

Falls in older age also have serious repercussions on the lives of family and friends.

 

How to prevent falls due to slips and trips?

Both slips and trips result from some a kind of unintended or unexpected change in the contact between the feet and the ground or walking surface. This shows that good housekeeping, quality of walking surfaces (flooring), selection of proper footwear, and appropriate pace of walking are critical for preventing fall accidents.

 

How Can a Physical Therapist Help?

If you are worried about falling or if you recently had a fall, your physical therapist can conduct a brief check (“screening”) of your fall risk. If the screening shows that you are at risk, the therapist will perform a thorough evaluation, including: A review of your medical history, medications, simple vision test, home safety assessment, simple screen of your thinking abilities, check of your heart rate, blood pressure measurements while you change positions (from sitting to standing), feet and footwear assessment, assessment of any nervous system disorders, such as stroke or Parkinson disease and even vestibular related pathologies. The therapist also will measure your leg strength, they will determine how quickly and steadily you walk, and will assess your balance using special tests.

Based on the evaluation results, your physical therapist will design an exercise and training program to improve your balance and strength. A recent systematic review of many published studies found that exercise-based programs in the home or in group settings are effective in preventing falls. These programs are especially effective when balance exercises are performed in a standing position without using much arm support.

Balance training has been shown to be an important and effective part of falls prevention. Your physical therapist will design exercises that challenge your ability to keep your balance, including such exercises as single-leg standing.

 

References

Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of fatal and nonfatal falls among older adults. Injury Prevention 2006. a; 12:290–5.

Tromp AM, Pluijm SMF, Smit JH, et al. Fall-risk screening test: a prospective study on predictors for falls in community-dwelling elderly. Journal of Clinical Epidemiology 2001; 54(8):837–844.

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):116–9.

Alexander BH, Rivara FP, Wolf ME. The cost and frequency of hospitalization for fall-related injuries in older adults. American Journal of Public Health 1992; 82(7):1020–3.

Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web–based Injury Statistics Query and Reporting System (WISQARS) [online]. Accessed November 30, 2010.

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