Skip to main content

Fatal Falls Rising in Older Adults


The Centers for Disease Control released a sobering report on mortality due to falls and other unintentional injuries in older adults.   The good news:  death from motor vehicle accidents has fallen since 2000, and death from other unintentional injuries such as suffocation, fire, and poisoning remain relatively rare.  The bad news:  between 2000 and 2013, the age-adjusted rate of death from falls in older adults nearly doubled, from 30 deaths per 100,000 adults to 57 deaths per 100,000 adults.  Among adults at the upper reaches of age, the death toll from falls is even more striking.  In 2012-13, there were 226 deaths due to falls per 100,000 adults.


Figure 2. Age-adjusted death rates, by cause of death among adults aged 65 and over: United States, 2000–2013

While concerning, these numbers only scratch the surface of the total burden of falls in older adults. According to the CDC, in any given year, one in three older adults will have a fall, and 20-30% of adults who fall will suffer a moderate or severe injury.  These injuries and the fear of falling can have profound impacts on quality of life and subsequent morbidity and mortality.  As a results, the total mortality burden from falls likely far exceeds the immediate risk of fall-related death cited in the CDC's latest report.

Why are fall-related deaths increasing?  The answer likely is complex, and includes changes in the distribution of underlying chronic illnesses as well as better reporting of falls as a contributor to death.  Whatever the cause, more action is needed, and emerging initiatives and interventions - such as a falls reduction program being studied by a consortium of Pepper Centers - will be vital to the solution.

by: Mike Steinman

Comments

Popular posts from this blog

Dying without Dialysis

There is a terrific article in this weeks Journal of Pain and Symptom Management by Fliss Murtagh of King's College in London about the epidemiology of symptoms for patients with advanced renal failure who die without dialysis.  This study is important because while we know that patients with advanced renal failure have a limited life expectancy and the average age of initiation of hemodialysis is increasing, we know little about the alternatives to hemodialysis.  Specifically, we know nothing about symptoms affecting quality of life among patients who elect not to start dialysis (so called "conservative management" - is this the best label?).  This article provides a terrific counterpoint to the article in last years NEJM showing that nursing home residents who initiated hemodialysis tended to die and decline in function (see GeriPal write up here). 

The study authors followed patients with the most advanced form of chronic kidney disease (the new name for renal failu…

Language Matters: Podcast with Brian Block and Anna DeForest

One of our first GeriPal posts was titled "Rant on Terminology," by Patrice Villars, NP.  In the spirit of looking back over our first 10 years, here is the opening paragraph to that post:

News Headlines read: Sen. Edward Kennedy loses battle with cancer. Really, he lost? I thought he died from a malignant brain tumor, an “aggressive” brain tumor. The median survival is less than a year for people for his particular tumor. Kennedy was diagnosed in May of 2008. He lived over 15 months after diagnosis. What a loser. He must not have fought hard enough. Huh? I thought he spent most of his life battling for social and health care reform in America. In this week's GeriPal podcast we take a deeper dive into this issue of language and medicine.  We are joined by guests Anna DeForest, MD, MFA, a resident in Neurology at Yale, and Brian Block, MD, a pulmonary critical care fellow at UCSF.  

Anna recently published a paper in the NEJM describing her reaction to hearing terms like, &…

The Dangers of Fleet Enemas

The dangers of oral sodium phosphate preparations are fairly well known in the medical community. In 2006 the FDA issued it’s first warning that patients taking oral sodium phosphate preparations are at risk for potential for acute kidney injury. Two years later, over-the-counter preparations of these drugs were voluntarily withdrawn by the manufacturers.  Those agents still available by prescription were given black box warnings mainly due to acute phosphate nephropathy that can result in renal failure, especially in older adults. Despite all this talk of oral preparations, little was mentioned about a sodium phosphate preparation that is still available over-the-counter – the Fleet enema.

Why Oral Sodium Phosphate Preparations Are Dangerous 

Before we go into the risks of Fleet enemas, lets spend just a couple sentences on why oral sodium phosphate preparations carry significant risks. First, oral sodium phosphate preparations can cause significant fluid shifts within the colon …