The CDC Injury Center’s Response to the Growing Public Health Problem of Falls Among Older Adults

Houry, Debra; Florence, Curtis S.; Baldwin, Grant T.; Stevens, Judy A.; McClure, Roderick John

doi:10.1177/1559827615600137

Cited by 142 publications

(104 citation statements)

References 22 publications

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“…Postural stability is essential for the high-quality performance of activities of daily living (ADLs) in older age (7). Impaired postural stability is strongly associated with a risk of falls, and its complications are getting worse with aging (8,9). According to World Health Organization projections, the proportion of the global population over 60 years old will rise from 10.0% in 2000 to 21.8% in 2050, and then to 32.2% in 2100 (10).…”

Section: Introductionmentioning

confidence: 99%

Effects of Overweight and Obesity on Postural Stability of Aging Females

Rezaeipour

Apanasenko²

2018

Middle East J Rehabil Health Stud

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Background: Weight gain modifies body geometry by adding mass to different areas of the body. Objectives: The aim of this study was to determine the effect of body mass index (BMI) groups on postural stability of elderly females in a quiet stance by measuring the center of pressure (CoP) velocity. Methods: This quasi-experimental study consisted of 77 inactive females over 65 years old (67.7 ± 3.5) who had come to the Sports Medicine Center (Kiev, Ukraine) in the summer of 2017. All participants were classified into normal, overweight, and obese groups based on BMI. Postural stability was taken in a quiet stance (static situation) on a foam mat with open (OE) and closed (CE) eyes in anteroposterior (AP) and mediolateral (ML) directions by the force platform. Each test was performed two times for 30 seconds, and CoP was recorded at a sampling rate of 200 Hz. Results: In the AP direction, obese females swayed significantly faster than females with normal weight during OE (1.1 cm/s and 0.84 cm/s, respectively) and CE (1.2 cm/s and 0.88 cm/s, respectively) conditions. In the ML direction, higher CoP velocities in females with normal weight were observed than in obese females under OE conditions (0.55 cm/s and 0.43 cm/s, respectively) and CE (0.76 cm/s and 0.56 cm/s, respectively). Conclusions: Obesity had a negative influence on postural stability in the AP direction. However, given the expansion of the support base, obese females were more stable than normal-weight females along the ML direction. Study outcomes can be useful for obese people, medical staff, and healthcare decision-makers.

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Section: Introductionmentioning

confidence: 99%

Effects of Overweight and Obesity on Postural Stability of Aging Females

Rezaeipour

Apanasenko²

2018

Middle East J Rehabil Health Stud

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“…Injury death rates from falls nearly doubled between 2000 and 2013, from 29 to 56 per 100,000 population (CDC, 2013). The increasing death rate combined with a growing older adult population means the direct medical costs of falls in the United States are projected to increase from about $35 billion in 2012 to over $100 billion in 2030 (Houry, Florence, Baldwin, Stevens, & McClure, 2016). Multiple individual and multifactorial interventions have been shown to reduce fall risk.…”

Section: Introductionmentioning

confidence: 99%

Lessons Learned From Implementing CDC’s STEADI Falls Prevention Algorithm in Primary Care

Casey

Parker

Winkler

et al. 2016

GERONT

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Background Falls lead to a disproportionate burden of death and disability among older adults despite evidence-based recommendations to screen regularly for fall risk and clinical trials demonstrating the effectiveness of multifactorial interventions to reduce falls. The Centers for Disease Control and Prevention developed STEADI (Stopping Elderly Accidents, Deaths, and Injuries) to assist primary care teams to screen for fall risk and reduce risk of falling in older adults. Purpose of the Study This paper describes a practical application of STEADI in a large academic internal medicine clinic utilizing the Kotter framework, a tool used to guide clinical practice change. Design and Methods We describe key steps and decision points in the implementation of STEADI as they relate to the recommended strategies of the Kotter framework. Strategies include: creating a sense of urgency, building a guiding coalition, forming a strategic vision and initiative, enlisting volunteers, enabling success by removing barriers, generating short-term wins, sustaining change, and instituting change. Results Fifty-six patients were screened during pilot testing; 360 patients were screened during the first 3 months of implementation. Key to successful implementation was (a) the development of electronic health record (EHR) tools and workflow to guide clinical practice and (b) the proactive leadership of clinical champions within the practice to identify and respond to barriers. Implications Implementing falls prevention in a clinical setting required support and effort across multiple stakeholders. We highlight challenges, successes, and lessons learned that offer guidance for other clinical practices in their falls prevention efforts.

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“…About 2600 adults ages 55 to 64 and 29 000 older adults died due to a fall in 2016 . The US older adult population is projected to grow by almost 50% between 2016 and 2030, resulting in increased falls and healthcare utilization if more is not done to prevent falls . Multiple risk factors are associated with falls in the aging population, some of which are modifiable such as vestibular disorders, postural hypotension, and use of certain medications, and they can be targeted to reduce falls …”

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confidence: 99%

Willingness to Change Medications Linked to Increased Fall Risk: A Comparison between Age Groups

Haddad

Karani

Bergen

et al. 2018

J American Geriatrics Society

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Objective: To describe and compare two age groups’ knowledge of medications linked to falls and willingness to change these medications to reduce their fall risk. Method: We analyzed data from community-dwelling adults age 55 and older (n=1,812), including 855 adults aged 55 to 64 years and 957 older adults (65 and older) who participated in the 2016 summer wave of the ConsumerStyles survey. ConsumerStyles is an annual web-based survey. The data are weighted to match the US Current Population Survey proportions on nine US Census Bureau demographic characteristics. Measurements: Survey respondents were asked about medication use, knowledge of side effects, their willingness to change their medications to reduce fall risk, communication in the previous year about fall risk with their healthcare provider, and their comfort in discussing fall risk with their healthcare provider. All data were weighted to match the 2016 population estimates. Descriptive statistics and chi-square tests (p ≤ 0.05) were used to identify differences between the two age groups. Results: About one-fifth of all respondents reported using at least one class of medication that increases fall risk. Older adults were less likely to report using medications for mood or sadness, less likely to report knowing the side effects of pain medications, and more willing to change their sleep medications compared with their younger counterparts. Among all respondents using these medication classes, less than one-third knew the potential fall-related side effects. However, most of them expressed willingness to change their medication if advised by their healthcare provider. Conclusion: Most older adults were unaware of potential fall risks associated with medications prescribed to address pain, difficulty sleeping, mood or sadness, and anxiety- or nervousness-related health issues. However, most were willing to change their medication if recommended by a healthcare provider.

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The CDC Injury Center’s Response to the Growing Public Health Problem of Falls Among Older Adults

Cited by 142 publications

References 22 publications

Effects of Overweight and Obesity on Postural Stability of Aging Females

Effects of Overweight and Obesity on Postural Stability of Aging Females

Lessons Learned From Implementing CDC’s STEADI Falls Prevention Algorithm in Primary Care

Willingness to Change Medications Linked to Increased Fall Risk: A Comparison between Age Groups

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