Why Are Falls So Dangerous for the Elderly?


Conditions like heart disease and cancer are known for their severity, especially for older adults. However, another cause of serious health consequences for seniors has become more and more common over the past decade: falls. According to the Centers for Disease Control and Prevention (CDC), one in four Americans aged 65 and older falls each year.

In 2018 alone, seniors reported nearly 36 million falls, 8.4 million of which resulted in fall-related injuries. Sadly, more than 32,000 elders died from falling that year. Most falls do not result in serious injuries, so how can such a seemingly innocuous accident be life-threatening for an aging loved one?

Consequences of Falls in the Elderly

The seriousness of a fall often depends on the nature of the accident. For example, how a senior lands when they fall could mean the difference between a broken hip, a traumatic brain injury (TBI), or a few bumps and scrapes. Fractured bones and soft tissue injuries (e.g., bruises, sprains and strains) are the most common fall-related injuries. Unfortunately for seniors, even minor trauma can require hospitalization, and many never regain the level of functionality and confidence they enjoyed before falling.

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Why Do Falls Cause Death in the Elderly?

Advanced age, frailty and pre-existing medical conditions decrease the likelihood that older individuals will recover from fall-related injuries. A team of researchers from the University of Rochester Medical Center set out to study how the effects of ground-level falls differ between elderly and non-elderly adults. While ground-level falls (ones that occur when an individual falls from a standing position) do not sound serious, they can cause severe injuries in seniors. The study, published in The Journal of Trauma: Injury, Infection, and Critical Care, found that older adults were three times as likely to die following a low-level fall compared to individuals younger than 70.

“There is the potential to minimize what people see as a relatively trivial issue, such as slipping and falling on a wet tile floor,” Julius Cheng, M.D., M.P.H., associate professor in the Department of Surgery at URMC and lead author of the study, explained in a news release. “Our research shows that falls from low levels shouldn’t be underestimated in terms of how bad they can be, especially in older patients.”

Another study conducted by researchers at the CDC’s National Center for Injury Prevention and Control found that nearly half (48.7 percent) of fall-related deaths among people aged 65 and older involved a head injury. However, even with less severe fall-related injuries, such as broken bones, the course of treatment and prognosis are still complicated for the elderly.

For example, hospitalization comes with risks. Even if a senior survives a fall and subsequent medical care, longer recovery times translate to longer hospital stays and increase the likelihood of discharge to a senior rehab facility or a long-term care facility. This increases vulnerability to hospital-acquired infections, such as pneumonia, C. diff and catheter-associated urinary tract infections (UTIs), which can even develop into sepsis. Hip fractures often require surgical procedures involving sedation and further trauma—two things that can jeopardize an older person’s life.

Psychological Effects of a Fall on the Elderly

Even complications from a non-fatal fall can ultimately render a senior incapable of caring for themselves. Only 22 percent of seniors in the URMC ground-level fall study were able to function on their own after being discharged from the hospital. Following such a traumatic and painful incident, even those older individuals who make a significant recovery tend to reduce their activity levels due to fear of repeat incidents. Sadly, this fear is warranted since one fall automatically increases an elder’s chances of falling again.

Many seniors are aware of how dangerous falls can be. Even if an aging loved one has never fallen or suffered a serious fall-related injury, fear of possibly getting hurt or becoming disabled can drive marked behavioral changes. Examples might include changes in activities of daily living (e.g., bathing, cooking, housekeeping), a reluctance to leave home and increased dependence on others for help.

While these lifestyle changes are understandable and meant to reduce the risk of falling, they can inadvertently lead to increased frailty and vulnerability to falls. Furthermore, such changes often result in withdrawal and social isolation that can contribute to depression, delirium or even dementia.

Read: Fear of Falling May Cause Depression in Older Adults

Prevention Is Key

The best way to prevent falls is to address and minimize hazards before they can pose a threat to an aging loved one’s health. Not every accident can be avoided, but taking certain precautions can extend a senior’s independence, help them feel more confident, and greatly reduce their risk of injury, disability and death.

Read: Fall Prevention Tips for Seniors

Sources: Trends in Nonfatal Falls and Fall-Related Injuries Among Adults Aged ≥65 Years - United States, 2012-2018 (https://doi.org/10.15585/mmwr.mm6927a5); FACT SHEET: Older Adult Falls (https://www.cdc.gov/steadi/pdf/STEADI_ClinicianFactSheet-a.pdf); Ground Level Falls Are Associated With Significant Mortality in Elderly Patients (http://dx.doi.org/10.1097/TA.0b013e3181efc6c6); Circumstances and Contributing Causes of Fall Deaths among Persons Aged 65 and Older: United States, 2010 (https://dx.doi.org/10.1111%2Fjgs.12702); Post-Fall Emotional Response (https://www.todaysgeriatricmedicine.com/archive/JF16p18.shtml)

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