The impact of falls in the elderly

The number of falls in the elderly is becoming a major public health problem in our society. In the past decade, life expectancy has increased from 75 years in 1990 to 79 years in 2009 in the US. It has been estimated that the number of persons aged 65 years and older in the US will double by 2050. In 2000, falls accounted for 45% of all injury-related inpatient stays with almost 750,000 hospitalizations. Fractures were the most common primary injury diagnosis, including 314,006 hip fractures. Injury following a fall is associated with a decreased quality of life and poor functional outcome, in severe injuries these effects continue for a prolonged period of time. In 2006, fall-related medical costs in the population aged ≥65 in the US amounted to US$19 billion for non-fatal and US$0.2 billion for fatal injuries. In this article, we provide a literature overview on the impact of falls in the elderly, the demands on healthcare, and the costs for our society.

[1]  E. Finkelstein,et al.  The costs of fatal and non-fatal falls among older adults , 2006, Injury Prevention.

[2]  J. Bond,et al.  Patients with recurrent falls attending Accident & Emergency benefit from multifactorial intervention--a randomised controlled trial. , 2005, Age and ageing.

[3]  M. Tinetti,et al.  Summary of the Updated American Geriatrics Society/british Geriatrics Society Clinical Practice Guideline for Prevention of Falls in Older Persons , 2022 .

[4]  Karim M Khan,et al.  Meta-analysis of the impact of 9 medication classes on falls in elderly persons. , 2009, Archives of internal medicine.

[5]  S. George,et al.  The Winchester falls project: a randomised controlled trial of secondary prevention of falls in older people. , 2008, Age and ageing.

[6]  M. Tinetti,et al.  Risk factors for falls among elderly persons living in the community. , 1988, The New England journal of medicine.

[7]  R A Marottoli,et al.  Decline in Physical Function following Hip Fracture , 1992, Journal of the American Geriatrics Society.

[8]  P. Corso,et al.  The acute medical care costs of fall-related injuries among the U.S. older adults. , 2005, Injury.

[9]  M. Tinetti,et al.  A multifactorial intervention to reduce the risk of falling among elderly people living in the community. , 1994, The New England journal of medicine.

[10]  Pekka Kannus,et al.  Alarming rise in fall-induced severe head injuries among elderly people. , 2007, Injury.

[11]  A. Campbell,et al.  Psychotropic Medication Withdrawal and a Home‐Based Exercise Program to Prevent Falls: A Randomized, Controlled Trial , 1999, Journal of the American Geriatrics Society.

[12]  Pamela W. Duncan,et al.  Guideline for the Prevention of Falls in Older Persons , 2001 .

[13]  P. Scuffham,et al.  Incidence and costs of unintentional falls in older people in the United Kingdom , 2003, Journal of epidemiology and community health.

[14]  S. Lord,et al.  Older people presenting to the emergency department after a fall: a population with substantial recurrent healthcare use , 2011, Emergency Medicine Journal.

[15]  Cameron Swift,et al.  Prevention of falls in the elderly trial (PROFET): a randomised controlled trial , 1999, The Lancet.

[16]  Peter Patka,et al.  Societal consequences of falls in the older population: injuries, healthcare costs, and long-term reduced quality of life. , 2011, The Journal of trauma.

[17]  Marcelo Coca-Perraillon,et al.  Incidence and mortality of hip fractures in the United States. , 2009, JAMA.

[18]  W. Leslie,et al.  Trends in Hip Fracture Rates in Canada , 2009 .

[19]  Philippe Autier,et al.  Functional outcome and quality of life following hip fracture in elderly women: a prospective controlled study , 2004, Osteoporosis International.

[20]  Jiaquan Xu,et al.  Deaths: preliminary data for 2009. , 2011, National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System.

[21]  S. Cummings,et al.  Risk factors for recurrent nonsyncopal falls. A prospective study. , 1989, JAMA.

[22]  Lillemor Lundin-Olsson,et al.  Fall and Injury Prevention in Older People Living in Residential Care Facilities: A Cluster Randomized Trial , 2002, Annals of Internal Medicine.

[23]  R. Rizzoli,et al.  Incidence of hip fracture over a 10-year period (1991-2000): reversal of a secular trend. , 2007, Bone.

[24]  M A Province,et al.  The effects of exercise on falls in elderly patients. A preplanned meta-analysis of the FICSIT Trials. Frailty and Injuries: Cooperative Studies of Intervention Techniques. , 1995, JAMA.

[25]  Peter Patka,et al.  Trends in fall-related hospital admissions in older persons in the Netherlands. , 2010, Archives of internal medicine.

[26]  D. Knol,et al.  Multifactorial intervention to reduce falls in older people at high risk of recurrent falls: a randomized controlled trial. , 2010, Archives of internal medicine.

[27]  M. Wald,et al.  Traumatic brain injury in the United States; emergency department visits, hospitalizations, and deaths, 2002-2006 , 2010 .

[28]  T. V. D. van der Cammen,et al.  The Epidemic of Hip Fractures: Are We on the Right Track? , 2011, PloS one.

[29]  M. Tinetti,et al.  Drugs and Falls in Older People: A Systematic Review and Meta‐analysis: II. Cardiac and Analgesic Drugs , 1999, Journal of the American Geriatrics Society.

[30]  S. Polinder,et al.  Rapid increase in hospitalizations resulting from fall-related traumatic head injury in older adults in The Netherlands 1986-2008. , 2011, Journal of neurotrauma.

[31]  R. Gangnon,et al.  Kenosha County Falls Prevention Study: A Randomized, Controlled Trial of an Intermediate‐Intensity, Community‐Based Multifactorial Falls Intervention , 2007, Journal of the American Geriatrics Society.

[32]  P. Kannus,et al.  Nationwide Decline in Incidence of Hip Fracture , 2006, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[33]  J. Langlois,et al.  Traumatic brain injury in the United States; emergency department visits, hospitalizations, and deaths , 2006 .

[34]  D M Buchner,et al.  Falls prevention over 2 years: a randomized controlled trial in women 80 years and older. , 1999, Age and ageing.

[35]  Orthopaedic Surgeons Panel On Falls Prevention.  Guideline for the Prevention of Falls in Older Persons , 2001 .

[36]  M. Tinetti,et al.  The effects of exercise on falls in elderly patients. A preplanned meta-analysis of the FICSIT Trials. Frailty and Injuries: Cooperative Studies of Intervention Techniques. , 1995, JAMA.

[37]  M. Tinetti,et al.  Drugs and Falls in Older People: A Systematic Review and Meta‐analysis: I. Psychotropic Drugs , 1999, Journal of the American Geriatrics Society.

[38]  Arlene I Greenspan,et al.  Injury hospitalizations: using the nationwide inpatient sample. , 2006, The Journal of trauma.

[39]  B. Stricker,et al.  Risk of falls after withdrawal of fall-risk-increasing drugs: a prospective cohort study. , 2007, British journal of clinical pharmacology.

[40]  R. Madhok,et al.  Downturn in hip fracture incidence. , 1996, Public health reports.

[41]  S. Silverman,et al.  Deterioration in Quality of Life Following Hip Fracture: A Prospective Study , 2000, Osteoporosis International.