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Analysis

Fall-related Death Rates Triple for US Seniors

By John Commins  
   June 04, 2019

The absolute number of fall-related deaths for seniors ages 75 and higher increased from 8,613 in 2000 to 25,189 in 2016.

U.S. seniors 75 and older saw a threefold increase in fall-related death rates in the first decades of the new century. And the likelihood that a fall would prove fatal also increased dramatically with older seniors, according to several new studies released today in JAMA.

The absolute number of fall-related deaths for seniors ages 75 and higher increased from 8,613 in 2000 to 25,189 in 2016, according to Netherlands researchers Klaas A. Hartholt, MD Reinier de Graaf Groep.

A further breakdown of the Hartholt data showed that the overall rate of death increased from nearly 52 per 100,000 people in 2000 to 122 per 100,000 in 2016.

Adjusted for different ages, fall-related deaths increased from about 61 per 100,000 men in 2000 to about 116 per 100,000 in 2016. Among women those rates grew from 46 per 100,000 in 2000 to about 106 per 100,000 in 2016, the Hartholt study found.

The older the person, the more likely that a fall would prove fatal. Rates of death increased by age group in 2016 from 42 per 100,000 among those ages 75 to 79 compared with about 591 per 100,000 among those 95 or older, the study found.

"The reasons for these increases aren't fully known," Hartholt and Reinier de Graaf Groep wrote, "although misclassification or incomplete recording of causes of death could have resulted in overestimation or underestimation of deaths from falls."

A separate study in the same issue of JAMA looked at the prevalence and cost of traumatic injuries between 2008-2014 when compared with common acute diseases.

Of the 11.7 million hospitalizations that occurred over the six-year span, traumatic injury accounted for 5.6% of the primary indicators for admission, with an annual average cost of more than $2.7 billion, another JAMA study showed.    

Elizabeth Burns, MPH, with the Centers for Disease Control and Prevention's Health Injury Center, said the findings in the JAMA studies can't be explained away simply by saying there are more older people now in the United States than there were in 2000. 

"Our fall death rates adjust for the growing number of older adults in the U.S.," Burns said in an email exchange with HealthLeaders.

"We found that fall death rates are increasing in every age group but especially among the oldest age groups," Burns said. "This could be due to older adults living longer and with chronic conditions like diabetes, and hypertension. These chronic diseases can increase fall risk. Older adults are also taking more medications, some of which can increase their fall risk."

A previous CDC study had estimated that treating falls cost the U.S. healthcare system $50 billion in 2015, including $29 billion paid by Medicare, $8.7 billion paid by Medicaid, and $12 billion from other payers. 

While hospitals, physicians and other providers are limited in what they can do to prevent falls outside the walls of their care venues, Burns said that educating older patients about the dangers of falls is a good start.

"Many older adults might not know they are at risk and that there are effective steps they can take to reduce their fall risk," she said.

Burns recommended that clinicians use CDC's fall initiative STEADI (Stopping, Accidents, Deaths, and Injuries) to screen for fall risk, assess modifiable risk factors, and intervene with evidence-based recommendations like reducing medications linked to fall risk or referring to physical therapy.

"It is important to talk about falls," Burns says. "Most falls can be prevented."  

“It is important to talk about falls. Most falls can be prevented. ”

John Commins is a senior editor at HealthLeaders.


KEY TAKEAWAYS

The older the person, the more likely that a fall would prove fatal.

Rates of death increased by age group in 2016 from 42 per 100,000 among those ages 75 to 79 to 591 per 100,000 among those 95 or older.

Of the 11.7 million hospitalizations that occurred from 2008-2014, traumatic injury accounted for 5.6% of the primary indicators for admission, with an annual average cost of more than $2.7 billion.


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