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Why Falls Can Turn Deadly as You Age

Nearly 39,000 older adults died from a fall in 2021, but experts say they can be prevented


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A stumble on uneven sidewalk or a trip over a shoelace may result in a scraped knee or a bruise for a small child. But for an older adult, falls can be serious, even deadly.

A new report from the Centers for Disease Control and Prevention (CDC) found a 7.6 percent increase in deadly falls for adults 65 and older from 2020 to 2021. The 38,742 fall-related deaths in 2021 (more than 100 per day) is in addition to the millions of major injuries older adults sustain each year from falls.

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When falls become serious

There are several reasons why falls become more dangerous as we get older. Bone and muscle loss, which becomes more common with age, increases the likelihood that a fall will result in a fracture, which can rob a person of his or her independence.

“For an older person who has some limitations in mobility, a fall can really make the difference in being able to walk again,” says Liron Sinvani, M.D., assistant professor at the Feinstein Institutes for Medical Research and the director of Geriatric Hospitalist Service at Northwell Health. Research shows hip fractures are to blame for nearly 30 percent of fall deaths among adults 65 and older.

Worsening eyesight and poor hearing can make it harder for older individuals to spot hazards. What’s more, studies show that older adults have slower reaction times and may not be able to catch themselves as quickly when they start to fall.

If your head hits before your hand, you could be left with a brain injury. Bleeding in the brain is especially a concern for the estimated 2 million Americans who take anticoagulants, commonly known as blood thinners. Almost half of fall deaths in the 65-plus population involve head injuries, according to a study published in the Journal of the American Geriatrics Society.

Recovery from serious injuries takes longer as you get older and can be especially challenging for those who are frail or are dealing with other medical conditions. Hospital stays can introduce infection risks, and medications to help manage pain can affect cognition.

Should you go to the doctor after you fall?

Yes. How soon you get there, though, depends on the severity of the fall.

Severe pain, loss of consciousness or a hit to the head necessitates immediate care, Sinvani says. If you didn’t hurt yourself, or walked away with minor scrapes, it’s still important to talk to your doctor, since falling once doubles your chances of falling again, according to the CDC. And next time, you might not be as lucky.

“It’s not enough to just say, ‘OK, this person fell. Let’s continue with our day,’ ” Sinvani says. “Understanding why that person fell becomes very important.” 

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Despite falls being common among the 65-plus population — about 1 in 4 older adults fall each year — they are not a normal part of aging, the CDC says. And health experts say they can be avoided.

Determining the cause is key

Certain medical conditions — like a vitamin D deficiency, diabetes, heart disease, vision loss or hearing loss — can make a person more prone to falls. Your doctor can check for these conditions and help you treat or manage them.

Common prescription and over-the-counter medications can cause side effects such as dizziness and sleepiness that can lead to falls. “This is something that can be intervened upon,” Sinvani says. For example, your doctor may be able to reduce your dosage or switch you to a drug that doesn’t come with the same effects.

If it’s a balance issue, assistive devices like a cane or walker can help. So can certain exercises. The National Institute on Aging recommends yoga, Pilates and tai chi to improve balance and muscle strength. Your doctor may also give you tips on how to fall-proof your home. Grab bars, bright lights and nonslip rugs are key.  

“These things need to be taken very seriously,” Sinvani says. “The cause of the fall needs to be investigated; there needs to be a home assessment, there needs to be a mobility assessment, and then there needs to be sort of a management plan. And by doing those things, you can actually prevent the fall that’s going to cause the death or the injury.”

Facts About Falls

For adults 65 and older:

  • Falls are the leading cause of injury and injury-related death.
  • Each year, 3 million people are treated in emergency departments for fall injuries.
  • There were 38,742 fall-related deaths in 2021.
  • Women report falling more than men.
  • The fall-related death rate was higher among men than women in 2021.
  • More than 95 percent of hip fractures are caused by falling.
  • Falls are the most common cause of traumatic brain injuries.
  • The 2021 estimate of fatal falls was higher than those during the previous 20 years. 

 Source: CDC

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