Falls are the leading cause of injury among adults aged ≥65 years (older adults) in the United States. In 2018, an estimated 3 million emergency department visits, more than 950,000 hospitalizations or transfers to another facility (e.g., trauma center), and approximately 32,000 deaths resulted from fall-related injuries among older adults.* Deaths from falls are increasing, with the largest increases occurring among persons aged ≥85 years (1). To describe the percentages and rates of nonfatal falls by age group and demographic characteristics and trends in falls and fall-related injuries over time, data were analyzed from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) and were compared with data from 2012 , 2014 , and 2016.5% of older adults reported falling at least once in the past year, and 10.2% reported an injury from a fall in the past year. The percentages of older adults reporting a fall increased between 2012 and 2016 and decreased slightly between 2016 and 2018. Falls are preventable, and health care providers can help their older patients reduce their risk for falls. Screening older patients for fall risk, assessing modifiable risk factors (e.g., use of psychoactive medications or poor gait and balance), and recommending interventions to reduce this risk (e.g., medication management or referral to physical therapy) can prevent older adult falls (https://www.cdc.gov/steadi).BRFSS is a landline and mobile telephone survey conducted annually in all 50 U.S. states, the District of Columbia (DC), and U.S. territories, with a median response rate of 49.9% in 2018. The survey collects information on health-related behavioral risk factors and chronic conditions among noninstitutionalized U.S. adults aged ≥18 years. † Information on falls and fall-related injuries is recorded every 2 years from adults aged ≥45 years by asking "In the past 12 months, how many times have you fallen?" If the response was one or more times, the respondent was asked "How many of these falls caused an injury? By an injury, we mean the fall caused you to limit your regular activities for at least a day or to go see a doctor." Responses to each of these questions ranged from 0 to 76 falls or fall-related injuries. Rates were calculated as the average number of falls and fall-related injuries per 1,000 older adults. Both questions were dichotomized to calculate the percentage of older adults who reported having at least one fall or fall-related injury. * www.cdc.gov/injury/wisqars. † https://www.cdc.gov/brfss.TABLE 1. Number of falls, percentages of adults reporting a fall, and rates* of self-reported falls in the past year among adults aged ≥65 years, by age group and selected characteristics (unweighted n = 142,834) -Behavioral Risk Factor Surveillance System, United States, 2018 Age group/ Characteristic No. † reporting a fall % (95% CI) § Rate* of falls (95% CI) Total (all aged ≥65 years)
Each year, more than 1 in 4 older adults in the United States report a fall and 1 in 10 a fall injury. Using nationally representative data from the 2016 US Behavioral Risk Factor Surveillance System, we evaluated demographic, geographic, functional, and health characteristics associated with falls and fall injuries among adults aged 65 years and older. Analyses included descriptive statistics and multivariable logistic regression to produce crude and adjusted percentages by characteristic. Characteristics most strongly associated with increased fall risk in order of adjusted percentage were depression, difficulty doing errands alone, and difficulty dressing or bathing. Characteristics most strongly associated with fall injury risk in order of adjusted percentage were depression, difficulty dressing or bathing, and being a member of an unmarried couple. The diverse health and functional characteristics associated with increased falls and fall injuries confirm the importance of screening and assessing older adult patients to determine their individual unique risk factors. Health care providers can use tools and resources from the Centers for Disease Control and Prevention’s STEADI (Stopping Elderly Accidents, Deaths, and Injuries) initiative to screen their older adult patients for fall risk, assess at-risk patients’ modifiable risk factors, and intervene to reduce risk by prescribing evidence-based interventions.
Introduction. Falls among older adults (age ≥65) are a common and costly health issue. Knowing where falls occur and whether this location differs by sex and age can inform prevention strategies. Objective. To determine where injurious falls that result in emergency department (ED) visits commonly occur among older adults in the United States, and whether these locations differ by sex and age. Methods. Using 2015 National Electronic Injury Surveillance System-All Injury Program data we reviewed narratives for ED patients aged ≥65 who had an unintentional fall as the primary cause of injury. Results. More fall-related ED visits (71.6%) resulted from falls that occurred indoors. A higher percentage of men’s falls occurred outside (38.3%) compared to women’s (28.4%). More fall-related ED visits were due to falls at home (79.2%) compared to falls not at home (20.8%). The most common locations for a fall at home were the bedroom, bathroom, and stairs. Conclusion. The majority of falls resulting in ED visits among older adults occurred indoors and varied by sex and age. Knowing common locations of injurious falls can help older adults and caregivers prioritize home modifications. Understanding sex and age differences related to fall location can be used to develop targeted prevention messages.
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