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ELDERLY FALL PREVENTION
Introduction
Unintentional injury is the leading cause of death from age 1-44 and is the third leading cause of death from ages 45-54. For those 65 and older it is the 9th leading cause of death with 34,000 deaths a year. Those 65 and older make up 13% of the population but 1/3 of the unintentional injury deaths. (Charts 1 and 3) In 2003 the CDC reported 109,277 deaths. In 2004 there were 29.6 million injuries and 2 million hospitalizations.1
http://www.cdc.gov/ncipc/fact_book/InjuryBook2006.pdf
Injuries lead to 114 million physician contacts per year, which is second only to respiratory complaints. They cost $117 billion in medical expenditures, second only to circulatory diseases, accounting for 10% of medical expenditures.1, 2 Unintentional injuries cover many types of preventable injuries including motor vehicle accidents, burns from scalds and fires, water related injuries, unintentional poisonings/overdoses, falls, sports-related injuries, accidental firearm injuries, and choking.
Despite the significant number of unintentional injuries less than half of the medical schools in the United States include injury prevention in the curricula. Of those that have non-clinical preventive medicine electives only 30% include injury prevention in the curricula.3 A survey study of 635 fourth year medical students found that on average students only answered 47% of the basic injury prevention questions correctly. Most of the injury prevention information taught occurred in family medicine and pediatrics rotations. Students ranked medical problems as more important and more preventable than injuries.2 This belies the fact that many injuries are avoidable with education, environmental prevention, clinical evaluation and physical therapy.
This module focuses on elderly falls, which lead to serious injuries and frequently loss of independence. Research and guidelines for fall prevention are relatively recent. The Veterans Administration National Center for Patient Safety has instituted a fall prevention program in 2004. As this module will emphasize, reducing the risk for falling is most effective when attacked in a multi-factorial fashion, however the interventions are often cheap and in some communities available through community services. The initial screening is simple and easily incorporated into a routine physical exam.
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