50+ Lifestyles

Adult Falls in Iowa, An Epidemic

By K. John Hartman MD, FACS
Vice Chair, Iowa Chapter of The American College of Surgeons Committee on Trauma
Trauma Services Medical Director, Genesis Davenport
General Surgeon, Davenport Surgical Group

Every 20 minutes in the United States an older adult dies from a fall. Over two million older adults are treated in emergency departments for nonfatal fall injuries each year in the United States. In the state of Iowa, injuries and deaths from falls have risen 20 percent over the last decade.  In 2015, the Iowa death rate from falls was 14.6 per 100,000 people.  This is higher than the U.S. rate of 9.6 per 100,000. In the United States, falls are the #1 cause of unintentional injury and death for people over the age of 65.

In the United States 1 out of every 3 adults over the age of 65 falls each year. Of those who fall, less than half tell their doctors. For older Iowans, falls account for 84 percent of the injury related hospitalizations per year. This is higher than the national average of 77.1 percent.

In Iowa the total charges for hospitalizations due to falls are $298 million per year.  For people over 65 annual charges are $44.3 million.  Fall related hospitalization costs are higher than any other injury. The  average charge per hospitalization in Iowa is around $26,400. In the United States direct medical costs for fall injuries total over $28 billion annually.

The impact on a person’s life after a fall is significant.  This goes beyond just the medical costs of treatment. Falls contribute to decreased ability to perform household tasks.  An overall reduced quality of life is reported.  Falls may result in a loss of independence for those over 65 years of age. Falls are the most common cause of traumatic brain injuries and 20 to 30 percent of people who fall suffer moderate to severe injuries. Most fractures among adults over 65 are caused by falls. Many people develop a fear of falling which limits their activities. This can lead to reduced mobility and loss of physical fitness, which increases the risk of another fall.

The CDC’s STEADI (Stopping Elderly Accidents Deaths and Injuries) initiative has established guidelines to help prevent falls.

1.) Have your doctor regularly review all your medicines both prescription and over-the-counter medications.  Many medications have side effects such as dizziness, confusion, weakness, and fatigue.  These can contribute directly to falls.

2.) Ask your doctor for an assessment of your risk of falling.  Share any history of recent falls with your doctor.

3.) Have your vision checked regularly.  The wrong glasses or conditions like glaucoma or cataracts can affect your vision. This can contribute directly to falls.

4.) Begin an exercise program to improve balance and strength. Lack of exercise can lead to weakness and increases your chances of falling.

5.) Make your home safer. Remove things you can trip over like electrical cords and throw rugs. Install grab bars in the bath tub and next to the toilet. Use nonslip mats in the bathtub and on shower floors. Have handrails and lights installed in stairways. Wear shoes both inside and outside.  Avoid going barefoot or wearing slippers. Keep items that you use frequently in a cupboard that is easy to reach, without using a step stool.

Falls and fall related injuries are significant problem for Iowans. They can lead to significant cost, and a reduction in overall quality of life and loss of independence for older Iowans. Contact your physician for a falls risk assessment and decrease your risk today.

References.

Cdc.gov/steadi

WWW.cdc.gov/injury/STEADI

WWW.idph.iowa.gov/falls-prevention

Falls Free.  Iowa Falls Prevention Coalition.  Policy brief: Falls in Iowa 2015.

IDPH, Falls Free, Advisory Council on Brain Injuries.  What You Can Do To Prevent Falls.

IDPH, Falls Free, Advisory Council on Brain Injuries.  Stay independent; Assess your Fall Risk