Falls are a leading cause of hospitalization and institutionalization for older adults in the U.S. and fall prevention efforts are an important part of geriatric education and health.
But in a new study from the University of Michigan, researchers found that despite prevention efforts, falls increase by about 1.5% annually, with wide variations in incidence based on geography.
It’s not clear why falls are increasing. Researchers adjusted for age, but the study could have captured population changes in health and function, or in prescribing patterns for medications associated with increased falls.
Or the results could reflect other factors––for instance, a more active older adult population could result in more falls.
Finally, the findings could reflect other changes in treatment and care, or how fall injuries are administratively coded.
The team was surprised by the wide variation in fall injury rates between low and high injury areas.
Counties with the highest (in the 90th percentile) fall rates had rates that were roughly 75% higher than counties with the lowest (10th percentile) fall rates.
This suggests that environmental factors may play a larger role in falls than has been previously discussed and that population-targeted risk management to target-specific areas may be cost-effective and beneficial.
Higher-risk areas were in the Central Plains and South. However, these areas are less populated so data is sparser and potentially less reliable.
Falls affect 4.5 million older adults in the U.S. and cost Medicare $15 billion to $30 billion annually.
Previous reports of increased fall injury trends are limited because data were self-reported and potentially undercounted by excluding moderate injuries.
This study examined national trends and geographic variability in fall injuries.
Researchers analyzed claims from 2016-2019 for adults 65 and older. The 1.5% average annual increase translates to an additional 106,000 new fall injuries, or an estimated $1 billion in new fall injury spending over the study period.
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The study is published in JAMA Network Open and was conducted by Geoffrey Hoffman et al.
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