Australia’s Senior Fall-death Rate Rose 37% over 10 Years.

Researchers from the Departments of Clinical Pharmacology and Aged Care at the Royal North Shore Hospital and from the Faculty of Medicine and Health at the University of Sydney demonstrated that the rate of fall deaths rose from 33 per 100,000 people to 45 in a recent, ten-year period. It is important to note that this dramatic increase is not the natural product of an aging population. Researchers age-adjusted their results, meaning statistical adjustments were made so that an older population could be compared apples to apples with a younger population from ten years prior.

Why Age-adjusted Fall-death Rates Are Rising Dramatically

Interestingly, this phenomenon is occurring across the globe in countries similar to Australia. For instance, the U.K. and U.S.A. have similar trends.^1,2 One of the most likely explanations puts this statistic in a positive light. Survival after the onset of common diseases such as heart disease, cancer, and stroke is on the rise. Logically, as death rates from top diseases fall, something else must take their places.

Seriousness of Falls Among Seniors

On the other hand, that positive outlook should not lull us into taking lightly the risk of falls among seniors.

• Falls are the leading cause of hospitalised injuries and injury deaths among older Australians, making up 77% of all injury hospitalisations.
• Falls account for 71% of injury deaths among older Australians.
• More than one in two falls that resulted in hospitalisation occur where the seniors live.
• Most hospitalised falls occurred on the same level (60%), such as a slip, trip, or stumble.
• Half of hospitalised falls involved a fracture (50%); open wounds were the next most common fall-related injury (14%).
• Australians aged 65 and over prove 8 times more likely to be hospitalised and 68 times more likely to die from a fall.

Protecting Seniors from Fall Injury

Research demonstrates that many fall injuries are preventable.^4-8 Where weakness, imbalance, or poor gait are present, seniors can call on the services of Advanced Physiotherapy & Injury Prevention to help prevent falls. Seniors should receive fall risk screening as part of routine physical exams. Just as adults who have never experienced a heart attack understand the importance of lowering blood pressure, patients with a demonstrated risk for falls often appreciate recommendations for early intervention.

Although falls are common in the elderly and the incidence rises with age, this should not discourage seniors from receiving screenings, especially after an accidental fall. Instead, falls should trigger an organized approach to fall prevention. Various intrinsic factors have a cumulative effect on a senior’s risk of falls, and that risk can be minimized by modifying a few intrinsic factors.⁹ People with leg weakness have roughly five times the risk of falling. Gait and balance disorders triple the likelihood of a fall.¹⁰   Through the combination of exercise physiology and physiotherapy, seniors can receive fall risk assessment and/or fall prevention therapy from Advanced Physiotherapy & Injury Prevention. 

A number of studies show how prescriptions for therapeutic exercise and injury-prevention coaching can reduce falls among seniors.^7,11-13 A fall prevention program at Advanced can include:

• Care planning from both qualified physiotherapists and an accredited exercise physiologist
• Gait training (including retraining on foot height and stride length)
• Balance training – proprioceptive training
• Transfer training
• Strengthening (lower & upper extremities)
• Posture assessment and training
• Environmental adaptation consultation
• ROM (lower & upper extremities)
• Falling techniques to reduce injury from a fall
• Evaluation for and training with adaptive equipment
• Trunk / core range of motion, stability, & strengthening
• Low-cost access to our patient-only gym

References

1. Wu H, Mach J, Le Couteur DG, Hilmer SN. Fall-related mortality trends in Australia and the United Kingdom: implications for research and practice. Maturitas. 2020 Dec 1;142:68-72. 
2. Centers for Disease Control and Prevention, National Center for Health Statistics. National Vital Statistics System, Mortality 2018-2021 on CDC WONDER Online Database, released in 2021. Data are from the Multiple Cause of Death Files, 2018-2021, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/ucd-icd10-expanded.html on April 19, 2023.
3.  Australian Institute of Health and Welfare (2022) Falls in older Australians 2019–20: hospitalisations and deaths among people aged 65 and over, AIHW, Australian Government, Last updated 12/05/2022 v7.0
4. Alexander BH, Rivara FP, Wolf ME. The cost and frequency of hospitalization for fall-related injuries in older adults. American Journal of Public Health. 1992; 82(7): 1020-3.
5. Nikolaus T, Bach M. Preventing falls in community-dwelling frail older people using a home intervention team (HIT): results from the randomized falls-HIT trial. J Am Geriatr Soc. 2003; 51: 300-5.
6. Gardner MM, Buchner DM, Robertson MC, et al. Practical implementation of an exercise-based falls prevention programme. Age Ageing. 2001; 30 (1): 77-83.
7. Province MA, Hadley EC, Hornbrock MC, Lipsitz LA, Mulrow CD, Ory MG, et. al. The effects of exercise on falls in elderly patients: A pre-planned meta-analysis of the FICSIT trials. Journal of the American Medical Association. 1995: 273:1341-7.
8. Rubenstein LZ, Josephson KR, Robbins AS. Falls in the nursing home. Annals of Internal Medicine. 1994;121:442-51.
9. Steinweg KK. The Changing Approach to Falls in the Elderly. Am Fam Physician. 1997; 56 (7): 1101-1111.
10. Bergland A, Laake K. Concurrent and predictive validity of “getting up from lying on the floor”. Aging Clin Exp Res. 2005; 17(3): 181-5.
11. Kane RL, Ouslander JB, Abrass IB, eds. Essentials of Clinical Geriatrics, 3rd ed: Instability and Falls. New York: McGraw-Hill, 1994;39:1194-1200.
12. Rubenstein LZ, Josephson KR, Robbins AS. Falls in the nursing home. Annals of Internal Medicine. 1994;121:442-51.
13. Judge JO, Lindsey C, Underwood M, Winsemius D. Balance improvements in older women: effects of exercise training. Physical Therapy. 1993; 73(4):254-65.