Falls continue to be the leading cause of fatal and nonfatal injuries among adults aged at least 65 years, according to a new report in the Centers for Disease Control and Prevention’s “Morbidity and Mortality Weekly Report,” published on Thursday in conjunction with the ninth annual Falls Prevention Awareness Day.
Older Americans experienced 29 million falls that resulted in 27,000 deaths and 7 million injuries and cost Medicare approximately $31.3 billion in 2014, the report authors said. The CDC analyzed data from the 2014 Behavioral Risk Factor Surveillance System survey to arrive at the findings.
“Older adult falls are increasing and, sadly, often herald the end of independence,” said CDC Director Tom Frieden, M.D., M.P.H. “Healthcare providers can make fall prevention a routine part of care in their practice, and older adults can take steps to protect themselves.”
The 2010 American Geriatrics Society/British Geriatrics Society Clinical Practice Guideline recommends that, to help prevent falls, healthcare professionals ask older adults about falls, assess their gait and balance, review their medications and prescribe interventions such as strength and balance exercises or taking vitamin D.
Based on those recommendations, the CDC developed its Stopping Elderly Accidents, Deaths and Injuries initiative, which has the goal of helping healthcare providers make fall prevention routine. STEADI includes information on how to screen for falls, online training for providers, videos on how to conduct functional assessments and informational brochures for providers, individuals and caregivers.
Additional highlights from the MMWR report:
- In 2014, approximately 2.8 million older adults were treated in emergency departments for fall-related injuries, and approximately 800,000 of these individuals subsequently were hospitalized.
- In 2014, 28.7% of older adults reported falling at least once within the past year.
- Women were more likely to report falling than men and were more likely to report a fall injury.
- The percentage of older adults who fell increased with age, from 26.7% among persons aged 65 to 74 years, to 29.8% among persons aged 75 to 84 years, to 36.5% among persons aged at least 85 years.
- Among states and the District of Columbia, the percentage of older adults who reported a fall ranged from 20.8% in Hawaii to 34.3% in Arkansas.
- The percentage of older adults experiencing fall injuries ranged from 7% in Hawaii to 12.9% in Missouri.
“Approximately half of older adults who fall do not discuss it with their healthcare provider, often because they fear this will lead to a loss of independence,” the report authors noted.
Payment and delivery reforms to encourage falls prevention activities among healthcare providers include incentives from the Centers for Medicare & Medicaid Services through the Welcome to Medicare Visit, Medicare Annual Wellness Visit and the Medicare Shared Savings Accountable Care Organization Program. CMS’ Physician Quality Reporting System in the Merit-Based Incentive Program also includes two falls prevention quality measures, the authors noted.
Bergen G, Stevens MR, Burns ER. Falls and Fall Injuries Among Adults Aged ≥65 Years — United States, 2014. MMWR Morb Mortal Wkly Rep 2016;65:993–998.