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Aging & Longevity

Despite efforts to keep senior citizens from falling, it seems to be more common

Study finds those who have fallen in last two years is more prevalent than in 1998

Jan. 19, 2015 – Falling is bad news for senior citizens - it is the most frequent cause of injury in older adults in the U.S. and leads to substantial disability and mortality. The really bad news is that despite increased cautions to seniors about these dangers the number of people 65 and older that are falling is increasing.

The prevalence among the elderly that say they have experienced a fall within the last two years has increased since 1998, according to a research letter published online by JAMA Internal Medicine.

But, there is some good news and some indication that all the warnings extended to seniors are having some benefits. The researchers did not find an increase in injuries from falling.

“We expected an increase because older adults are getting older and there are more 80 and 90 year old adults than before, but we were very surprised to find that the increase in falls was not due to the changing demography,” says lead author Christine Cigolle, M.D., M.P.H., assistant professor in the departments of Family Medicine and Internal Medicine at the University of Michigan and a research scientist at the VA Ann Arbor Healthcare System Geriatric Research, Education and Clinical Center (GRECC).

“We saw a higher number of falls across all age groups - not just the oldest –and that was unexpected.” 

Cigolle and coauthors looked at time trends in falling in a nationally representative sample of middle-aged and older adults in the Health and Retirement Study.

Falling was defined by the researchers as at least one self-reported fall in the preceding two years. The authors hypothesized that any increase in prevalence would be due to changes in the age structure of the population.

Study results show that among all adults 65 years or older, the two-year prevalence of self-reported falls increased from 28.2 percent in 1998 to 36.3 percent in 2010.

“Contrary to our hypothesis, we observed an increase in fall prevalence among older adults that exceeds what would be expected owing to the increasing age of the population.

Fortunately Injuries Did Not Increase

Despite the greater prevalence of reported falls, however, the study did not find that older adults were reporting more fall injuries.

Authors note that programs like “Matter of Balance” that focus on making older adults more aware of balance and provide strategies to reduce risks of falling, may also improve reporting. However, further research is needed to identify possible reasons behind the numbers, such as an increase in fall risk factors (e.g., cardiovascular and psychiatric medications that may have side effects like dizziness) or an increase in fall risk behavior.

“It’s possible that older adults are more aware of fall risk and may be more likely to report it now than before,” says Cigolle, who is also a member of the Institute of Gerontology and the Institute for Healthcare Policy and Innovation.

“However, if the prevalence of falls is actually increasing as much as it seems to be, we need to do more work to identify possible factors and how we can address what we know to be a high risk among a vulnerable group.”

U-M is among 10 clinical trial sites in the country for a major study on preventing fall injuries among the elderly and to find effective, evidence-based strategies to address the personal and public health burden of falls. The trial is funded by the National Institutes of Health and the Patient-Centered Outcomes Research Institute (PCORI).  GRECC Director Neil Alexander, M.D., M.S., professor in the Division of Geriatrics and Palliative Medicine at the U-M Medical School, is the lead investigator for the U-M site.

Dr. Cigolle is supported by a grant from the National Institute on Aging.

Additional Authors: Jinkyung Ha, Ph.D.; Lillian Min, M.D., MSHS; Pearl G. Lee, M.D. M.S; Neil Alexander, M.D. M.S., all of U-M. Caroline Blaum, M.D., M.S., formerly of U-M and now with New York University Langone Medical Center.
Tanya Gure M.D., of Ohio State University Wexner Medical Center.  

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