FALLS – July 2009


By J. Manuel Cordova, M.D.

(part I)


falling_manA serious fall can change your life forever! Falls are more common in people over age 60 and have not always been recognized as a serious health problem.

Research studies show the frequency and consequences of falls reveal their multifactor origin and demonstrate that they can be prevented by addressing the factors that increase a person’s risk of falling.

Approximately 35-40% of people age 65 and over fall in any given year. Half of the people who fall will do so more than once and the incidence rate increases steadily after age 60. About 50% of people over age 80 fall in a given year.

Falls are attributable for 87% of all fractures and over 95% of hip fractures in this age group. The second leading cause of brain and spinal cord injuries in older adults is the result of a fall. In the year 2005, there were over 350,000 hip fractures in the U.S.

Women are more likely to fall than men, and more than half of all falls occur in the home. Many of the visits to emergency rooms for patients over the age of 60 are related to falls and approximately half are admitted to the hospital.

Falls are associated with the increased risk of nursing home placement, body function decline and continued fear of falling.

Accidental injuries, including falls, represent the 5th leading cause of death in persons over age 65.

FACTORS: Vision impairment, muscle weakness, reaction to medications, balance and gait abnormalities, impaired thinking, arthritis, neurological disorders, Parkinson’s disease, recent hospitalization, osteoporosis, under weight, fragility, etc.

The primary risk factors in nursing homes include inappropriate use of medicines, inadequate use of cane or walker, nutritional deficiencies and inappropriate physician support by a qualified Geriatrics Specialist.

Falls may result in serious soft tissue injuries, fractures, lacerations and head trauma. The injury rates are higher in institutional settings by as much as 10-25%.

CONSEQUENCES OF FALLING: Falls are very costly for older persons, both in terms of health care dollars and in the loss of physical function and independence. The treatment cost of a hip fracture in the United States was recently estimated to be over $20,000 for care alone during the first year following the injury.

Falls account for approximately 20% of the restricted activity days in retired people; more than any other single health condition.

Older people who have suffered an injury from a fall may require restricted activity for several months or longer because of residual physical impairment. The fear of falling again also creates a psychological impairment. At least 50% of those who fall have fallen as a result of ‘fear of falling’ which then leads to long-term restriction of activities. Injuries from falls are a major factor in determining nursing home placement.

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