Copyright 2007 American Academy of Orthopaedic Surgeons
Prevention of Falls: Facts
Falls are the leading cause of fatal and nonfatal injuries in people 65 and older in the United States.
Falls can happen anytime and anyplace to people of any age, but most falls by people 65 years of age and older occur in the home during everyday activities. You can fall walking across a cluttered living room floor, in a slippery bathroom or while standing on a stool reaching into a cupboard.
The number of falls and the severity of injury resulting from falls increases as people get older. The most common serious injuries are head injuries, wrist fractures, spine fractures, and hip fractures.
The cost of falls among older people is enormous because of the high death toll, disabling conditions and recovery in hospitals and rehabilitation institutions. The United States spends an estimated $20.2 billion annually for the treatment of injuries to older people after falls. The majority of the cost is for hip fracture care, which averages $35,000 per patient.
30 percent of people over the age of 65 will fall each year.
90 percent of the 300,000 hip fractures treated annually in the United States occur as a result of a fall.
By the year 2000, there will be an estimated 350,000 fractures annually, nearly 1,000 hip fractures a day.
Approximately 25 percent of hip fracture patients will make a full recovery; 40 percent will require nursing home admission; 50 percent will be dependent upon a cane or a walker; and 20 percent will die in one year.
The National Osteoporosis Foundation reports 35,700 deaths each year from complications from hip fractures as a result of osteoporosis.
There is a pattern to falls among the elderly. The fear of falling, then the injury, followed by hospitalization, decreased independence and mobility, and often relocation to a nursing or residential institution. Falls can be a major life-changing event that robs the elderly of their independence.
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Don't panic. Assess the situation and determine if you are hurt.
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Slide or crawl along the floor to the nearest couch or chair and try to get up.
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If you can't get up, call for help.
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If you are alone, crawl slowly to the telephone and call 911 or relatives.
Medical Risk Factors
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Cardiac arrhythmias (irregular heartbeat) and blood pressure fluctuation
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Cancer that affects bones
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Depression, Alzheimer's disease, and senility
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Arthritis, hip weakness or imbalance
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Neurologic conditions, strokes, Parkinson's disease, multiple sclerosis
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Urinary and bladder dysfunction
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Vision or hearing loss
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Side effects of medicine
Personal Risk Fctors
Personal risk factors account for approximately 75 percent of the risk of falls and are related to acquired disabilities, age-related changes and current diseases.
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Age. The rate of hip fractures increases after age 50, doubling every five to six years.
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Activity. Lack of weight-bearing exercise leads to decreased bone strength.
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Gender. Reduced levels of estrogen after female menopause can result in osteoporosis. Women have two to three times as many hip fractures as men and a 20 percent chance of a hip fracture during their lifetime.
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Habits. Smoking and/or excessive alcohol intake decreases bone strength.
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Heredity. Caucasians and Asians with small, slender body structures are at risk; so are people who have a family history of fractures later in life.
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Nutrition. Low calcium dietary intake, reduced calcium absorption and inadequate vitamin D are factors in osteoporosis.
Risk Factors in the Home
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60 percent of falls occur at home, 30 percent occur in the community and 10 percent occur in nursing homes or other institutions.
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About 25 percent of all falls are the result of hazards such as slippery or wet surfaces, poor lighting, inadequate footwear and cluttered pathways in a home.
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Most fractures are a result of a fall in a home, usually related to everyday activities such as walking on stairs, going to the bathroom or working in the kitchen.
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Get an annual physical and eye examination, particularly an evaluation of cardiac and blood pressure problems.
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Maintain a diet with adequate dietary calcium and vitamin D.
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Participate in an exercise program for agility, strength, balance, and coordination.
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Keep an up-to-date list of all medications and provide it to all doctors with whom you consult.
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Know the side effects of your medications.
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Make sure all medications are clearly labeled and stored in a well-lit area according to instructions.
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Take medications on schedule with a full glass of water, unless otherwise instructed.
Stairs
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Provide enough light to see steps clearly.
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Keep stairs free of clutter.
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Cover stairs with tightly woven carpet or non-slip treads.
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Install sturdy handrails on both sides of the stairway.
Bathroom
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Keep a night-light on in the bathroom.
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Use bathroom rugs with nonskid backing.
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Install handrails in the bathtub and toilet areas.
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Place a rubber mat or nonskid strips on the bathtub/shower floor.
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Leave the bathroom door unlocked, so it can be opened from both sides.
Kitchen
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Avoid climbing and reaching to high shelves.
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Use a stable step stool with handrails.
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Arrange storage at counter level.
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Clean up spills as soon as they happen and don't wax floors.
Living Area
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Arrange furniture to provide an open pathway between rooms.
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Remove low tables, footrests and other items from the pathway.
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Keep electrical and telephone cords out of the pathway.
Bedroom
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Remove throw rugs, extension cords, and other floor clutter.
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Install a bedroom night-light.
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Use a normal-height bed. Before leaving your bed, sit on the edge for a time to make sure you are not dizzy.
Footwear
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Wear low-heeled shoes with non-skid soles.
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Tied shoes with a fairly snug fit are preferred, but keep the laces tied.
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Avoid shoes with thick heavy soles.
Last reviewed and updated: August 2007
AAOS does not review or endorse accuracy or effectiveness of materials, treatments or physicians.
Copyright 2007 American Academy of Orthopaedic Surgeons
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The American Academy of Orthopaedic Surgeons
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Rosemont, IL 60018
Phone: 847.823.7186
Email: orthoinfo@aaos.org
