Fall Prevention Fact Sheet
Wisconsic Chamber Foundation and The National Center for Injury Prevention
Each year many thousands of older Americans are injured as a result of falls. Nearly 16,000 people died from falls in 2001. Eighty percent of those who died were more than 65 years old. Falls are the leading cause of injury-related death for people more than 80 years old. Falls are also the leading cause of injury and hospital admissions among older adults.
For older adults, falls and resulting injuries may mean that they are no longer able to lead an active, independent life. Many changes that accompany aging can contribute a person’s greater risk of falling and being injured such as changes in vision, hearing, strength, and coordination. Older people also are more likely to have conditions that may affect their balance, such as diabetes, and many medications may cause dizziness or light-headedness. Many falls are also due to hazards that are easy to overlook but also easy to fix.
Small changes in homes and lifestyles can help prevent falls.
To Help Prevent Falls:
- Keep up a regular program of exercise. This can help your strength, balance, and coordination. Check with your doctor or physical therapist to plan an exercise program that’s right for you.
- Have your vision and hearing tested periodically. Wear a properly fitted hearing aid and eyeglasses if recommended by your doctor.
- Talk to your doctor or pharmacist about the side effects of the medications (including non-prescription medicines) you are taking. They could affect your coordination or balance.
- Get up slowly from sitting or lying down.
- Drink plenty of liquids, particularly when it is hot, to avoid becoming dehydrated.
- Wear low-heeled rubber-soled shoes that fully support your feet. Don’t wear smooth-soled slippers or just socks where you could easily slip.
- Keep one hand on a handrail when going up or down stairs.
- Use an assistive device such as a cane or a walker.
- Keep regularly used items within easy reach. Do not stand on a chair or table to reach something. Use a “reach stick” (a special grabbing tool available at most medical supply stores) to reach an item on an upper shelf.
Stairways, hallways, and pathways should:
- Have good lighting and light switches at the top and bottom of stairs
- Be free of clutter and objects you could trip over
- Have firmly attached carpet or abrasive strips or rubber treads to secure footing
- Have handrails running the whole length on both sides of all stairs
In the bathroom:
- Place grab bars in tub/shower and near toilet
- Use nonskid mats or abrasive strips in tub/shower and on surfaces that may get wet
Bedrooms should have:
- Night light(s)
- Lamp or light switch within reach of the bed
- Carpet or area rugs firmly attached to the floor
- A telephone within easy reach of the bed
In living areas:
- Place electrical cords and telephone wires away from walking paths
- Secure rugs to the floor and make sure carpets lie flat
- Arrange furniture and other objects so they do not interfere with walking
Outside the home:
- Have outdoor lights at all entrances
- Repair any cracks, holes, or other damage to walkways, steps, and porches
- Remove any clutter or debris
- Consider using non-skid material or reflective paint on steps
For More Information
NationalCenterfor Injury Prevention and Control
4770Buford Highway, NEMailstop K-63
Atlanta, GA 30341
For more complete information on simple, relatively inexpensive repairs and safety recommendations for your home and a free copy of the booklet Home Safety Checklist for Older Consumers, contact:
U.S.Consumer Product Safety Commission
800-638-2772, 800-638-8270 (TTY)
For a complete list of publications on health and aging from the National Institute on Aging contact:
National Institute on AgingInformation Center
800-222-2225, 800-222-4225 (TTY)
How serious is the problem?
- More than one-third of adults ages 65 years and older fall each year (Hornbrook 1994; Hausdorff 2001).
- Among older adults, falls are the leading cause of injury deaths (Murphy 2000) and the most common cause of nonfatal injuries and hospital admissions for trauma (Alexander 1992).
- In 2001, more than 1.6 million seniors were treated in emergency departments for fall-related injuries and nearly 388,000 were hospitalized (CDC 2003).
What outcomes are linked to falls?
- In 2001, more than 11,600 people ages 65 and older died from fall-related injuries (CDC 2003). More than 60% of people who die from falls are 75 and older (Murphy 2000).
- Of those who fall, 20% to 30% suffer moderate to severe injuries such as hip fractures or head traumas that reduce mobility and independence, and increase the risk of premature death (Sterling 2001).
- Among people ages 75 years and older, those who fall are four to five times more likely to be admitted to a long-term care facility for a year or longer (Donald 1999).
- Falls are a leading cause of traumatic brain injuries (Jager 2000).
- Among older adults, the majority of fractures are caused by falls (Bell 2000).
- Approximately 3% to 5% of older adult falls cause fractures (Cooper 1992; Wilkins 1999). Based on the 2000 census, this translates to 360,000 to 480,000 fall-related fractures each year.
- The most common fractures are of the vertebrae, hip, forearm, leg, ankle, pelvis, upper arm, and hand (Scott 1990).
Who is at risk?
- White men have the highest fall-related death rates, followed by white women, black men, and black women (CDC 2003).
- Women sustain about 80% of all hip fractures (Stevens 2000).
- Among both sexes, hip fracture rates increase exponentially with age (Samelson 2002). People ages 85 years and older are 10 to15 times more likely to sustain hip fractures than are people ages 60 to 65. (Scott 1990).
What is the effect of hip fractures?
- Of all fall-related fractures, hip fractures cause the greatest number of deaths and lead to the most severe health problems and reduced quality of life (Wolinsky 1997; Hall 2000).
- In 1999 in the United States, hip fractures resulted in approximately 338,000 hospital admissions (Popovic 2001).
- Most patients with hip fractures are hospitalized for about one week (Popovic 2001). Up to 25% of community-dwelling older adults who sustain hip fractures remain institutionalized for at least a year (Magaziner 2000).
- In 1991, Medicare costs for hip fractures were estimated to be $2.9 billion (CDC 1996).
- From 2000 to 2040, the number of people age 65 or older is projected to increase from 34.8 million to 77.2 million. For people over 85, the relative growth rate is even faster (U.S. Bureau of the Census 1998). Given our aging population, by the year 2040, the number of hip fractures is expected to exceed 500,000 (Cummings 1990).
How can seniors reduce their risk of falling?
Through careful scientific studies, researchers have identified a number of modifiable risk factors:
- Lower body weakness (Graafmans 1996)
- Problems with walking and balance (Graafmans 1996; AGS 2001)
- Taking four or more medications or any psychoactive medications (Tinetti 1989; Ray 1990; Lord 1993; Cumming 1998).
Seniors can modify these risk factors by:
- Increasing lower body strength and improving balance through regular physical activity (Judge 1993; Lord 1993; Campbell 1999). Tai Chi is one type of exercise program that has been shown to be very effective (Wolf 1996).
- Asking their doctor or pharmacist to review all their medicines (both prescription and over-the-counter) to reduce side effects and interactions. It may be possible to reduce the number of medications used, particularly tranquilizers, sleeping pills, and anti-anxiety drugs (Ray 1990).
- Strong studies have shown that some other important fall risk factors are Parkinson’s Disease, history of stroke, arthritis (Dolinis 1997), cognitive impairment (Tromp 2001), and visual impairments (Dolinis 1997; Ivers 1998; Lord 2001). To reduce these risks, seniors should see a health care provider regularly for chronic conditions and have an eye doctor check their vision at least once a year.
What other things may help reduce fall risk?
- Because seniors spend most of their time at home, one-half to two-thirds of all falls occur in or around the home (Nevitt 1989; Wilkins 1999). Most fall injuries are caused by falls on the same level (not from falling down stairs) and from a standing height (for example, by tripping while walking) (Ellis 2001). Therefore, it makes sense to reduce home hazards and make living areas safer.
- Researchers have found that simply modifying the home does not reduce falls. However, environmental risk factors may contribute to about half of all home falls (Nevitt 1989).
- Common environmental fall hazards include tripping hazards, lack of stair railings or grab bars, slippery surfaces, unstable furniture, and poor lighting (Northridge 1995; Connell 1996; Gill 1999).
To make living areas safer, seniors should:
- Remove tripping hazards such as throw rugs and clutter in walkways;
- Use non-slip mats in the bathtub and on shower floors;
- Have grab bars put in next to the toilet and in the tub or shower;
- Have handrails put in on both sides of stairways;
- Improve lighting throughout the home.
- Exercise – improve balance and strength
- Clear the way – remove tripping hazards
- Check your vision and hearing
- Light the way – use nightlights and fully light stairways
- Use handrails on stairs, grab bars in bath
- Wear sturdy, rubber-soled shoes
- Take your time – don’t rush
- Review medication side-effects with doctor or pharmacist
- Stay within your reach – maintain balance
- Stay hydrated – drink plenty of liquids
- Falls and Hip Fractures Among Older Adults