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July 22, 2019 · 11:03 pm

Serious falls are a health risk for adults UNDER 65

As a senior citizen I am well aware of the danger of falls for my age group The Natiional Council on Aging reports: “Falls are the leading cause of fatal and non-fatal injuries for older Americans. Falls threaten seniors’ safety and independence and generate enormous economic and personal costs.”

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So, I was surprised to learn that adults UNDER 65 were also very much at risk for falls.

Adults who take several prescription medications are more likely to experience serious falls, say Yale researchers and their co-authors in a new study. This heightened risk can affect middle-aged individuals — a population not typically viewed as vulnerable to debilitating or fatal falls, the researchers said.

To identify factors that put adults at risk for serious falls, the research team used patient data from the Veterans Aging Cohort Study (VACS), a national study of individuals who receive care through the Veterans Health Administration (VA). They identified 13,000 fall cases and compared them to controls of similar age, race, sex, and HIV status. The fall risk factors included prescription medication use, and alcohol and illegal drug use.

The researchers found that falls were a problem for middle-aged patients. “Providers typically think about falls in people over age 65. But these people were primarily in their 50s and falls were an important concern,” said Julie Womack, lead author and associate professor at Yale School of Nursing.

The study also noted that the simultaneous use of multiple medications, known as polypharmacy, plays a significant role in serious falls among patients who are HIV positive and those who are not. The researchers examined HIV status because people treated for HIV take several medications and often at a younger age.

Medications that were associated with serious falls included those commonly used to treat anxiety and insomnia (benzodiazepines), as well as muscle relaxants and prescription opioids.

Another important finding is the role of alcohol and illegal drug use in falls, Womack said.

The study suggests that programs designed to prevent serious falls in older adults may need to be modified to address risks for middle-aged adults. “Fall risk factors are highly prevalent in the Baby Boomer generation more generally. The next step is to look at interventions for the middle aged,” said Womack. Those interventions could address drinking and illicit drug use in addition to polypharmacy. “When we’re thinking about fall prevention programs we have to think about alcohol and substance use. We need to help individuals cut back.”

Reducing falls in middle-aged and older adults is vital because falls contribute to increased risk of injuries, hospitalizations, and death, said Womack.

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October 30, 2012 · 7:04 pm

What About Seniors Falling?

Falling down is a serious problem for senior citizens. For seniors, 65 years and older, one out of three falls each year. Half of these fall more than once. Seniors fall more often with each decade of life. Women are more likely to fall than men, but men are more likely to sustain a fatal fall injury. These statistics refer to individuals living in the community, not nursing homes.

So says, Adnan Arseven, MD, AGSF, Division of Internal Medicine and Geriatrics at Northwestern Memorial Hospital, speaking before the hospital’s Healthy Transitions Program®.

Dr. Arseven defined falling as “coming to rest inadvertently on the ground or at a lower level.” This is not as a result of loss of consciousness or hazardous conditions, like slipping on ice.

The Centers for Disease Control and Prevention, CDC, said, “Among older adults (those 65 or older), falls are the leading cause of injury death. They are also the most common cause of nonfatal injuries and hospital admissions for trauma.

“In 2010, 2.3 million nonfatal fall injuries among older adults were treated in emergency departments and more than 662,000 of these patients were hospitalized.

“In 2010, the direct medical costs of falls, adjusted for inflation, was $30.0 billion.”

What outcomes are linked to falls?

• Twenty to thirty percent of people who fall suffer moderate to severe injuries such as lacerations, hip fractures, or head traumas. These injuries can make it hard to get around or live independently, and increase the risk of early death.
• Falls are the most common cause of traumatic brain injuries (TBI). In 2000, TBI accounted for 46 percent of fatal falls among older adults.
• Most fractures among older adults are caused by falls. The most common are fractures of the spine, hip, forearm, leg, ankle, pelvis, upper arm and hand.
• Many people who fall, even if they are not injured, develop a fear of falling. This fear may cause them to limit their activities, which leads to reduced mobility and loss of physical fitness, and in turn increases their actual risk of falling.
• The death rates from falls among older men and women have risen sharply over the past decade.
• In 2009, about 20,400 older adults died from unintentional fall injuries.
• Men are more likely than women to die from a fall. After taking age into account, the fall death rate in 2009 was 34 percent higher for men than for women.
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