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We offer a complimentary fall-risk and/or home safety assessments to our managed care seniors. Please call our Wellness Center at 760-969-6550. Falls A Common Concern of Seniors. Falls: A Common Concern of Seniors. More than 1/3rd of adults 65+ fall each year in US
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We offer a complimentary fall-risk and/or home safety assessments to our managed care seniors. Please call our Wellness Center at 760-969-6550. FallsA Common Concern of Seniors
Falls: A Common Concern of Seniors • More than 1/3rd of adults 65+ fall each year in US • 50% of seniors that fall have fallen before • As the Senior population increases, so will the absolute number of falls
By Age Per Year 65- 69 22.4% 70- 74 27.9% 75- 79 31.4% 80- 84 39.6% Who Falls?
Who Falls? • Women 65+ 30% • Men 65+ 13% • Gender Differences decrease after 75; at 85 Men = Women By Sex
Community: 0.2 - 0.8 per person per year Hospital: 0.6 - 2.9 per person per year Long-term Care: 0.6 - 3.6 Who Falls? By Living Environment (rates)
Fear of falling Falls cause
Falls cause: • Fear of falling • limits activities • leads to decreased mobility/fitness - increases social isolation - increases actual risk of falling
Fear of falling Increased risk of Nursing Home Placement Falls cause
Falls cause • Increased risk of Nursing Home Placement - those 75+ who fall are 4-5x more likely to be admitted to long-term care for 1 + years
Fear of falling Increased risk of Nursing Home Placement Moderate to severe injuries Falls cause
Moderate to severe injuries - bruises, - traumatic brain injuries - accounts for 46% of fatal falls - fractures: 6% of falls, including, spine, hip, leg, pelvis, ankle upper arm and hand Falls cause
Fear of falling Increased risk of Nursing Home Placement Moderate to severe injuries Increased risk of death Falls cause
Falls cause • Increased risk of death - 15,800 annual deaths in seniors d/t fall (2005); 1.8 Million treated in ER • 85% percent of deaths from falls from seniors 75 and older • after 75 years, white men have highest fatality rates > white women > black men > black women - Men are more likely to die than women (49% higher mortality rates)
Hip Fractures in Seniors • 1% of falls result in hip fractures ($10 billion cost) • 350,000 senior hip fractures/year • 60% have restricted mobility • 25% remain functionally more dependent • 25% die within 1 year
Reasons Why Falls Occur Intrinsic FactorsExtrinsic Factors Normal Aging Changes FALLS
Normal Aging Changes Neurologic - proprioception reaction time righting reflexes Intrinsic Factors
Normal Aging Changes Neurologic Gait - Slower - Stride length and arm swing - Body flexion & head/torso; knees shoulders forward - Lateral sway Intrinsic Factors
Normal Aging Changes Neurologic Gait Vision Accommodation Dark adaptation Intrinsic Factors
Normal Aging Changes Neurologic Gait Vision Muscle mass Intrinsic Factors
Reasons Why Falls Occur Intrinsic FactorsExtrinsic Factors Normal Aging Changes Chronic & Acute Disease FALLS
Intrinsic Factors Chronic Disease • Cataracts, macular degeneration • Arthritis • Parkinsons, Strokes • The “Dizzy’s”
Chronic Disease The “Dizzy’s” 27% of seniors 65+ report during last month 37% last > 1 minute 50% of those 80 or greater that are dizzy due to Benign Positional Vertigo Usually due to many causes: - Meniere's disease, circulation, blood pressure drops, - anemia, heart rhythms, anxiety/depression Intrinsic Factors
Intrinsic Factors Acute Illness/Confusion • UTI, pneumonia, diarrhea, dehydration, vomiting
Reasons Why Falls Occur Intrinsic FactorsExtrinsic Factors Normal Aging Changes Chronic & Acute Disease Trouble walking FALLS
Trouble Walking (Dysmobility) - Trouble walking increases with age - > 65 y/o: 15% - 85 y/o: 25% men; 33% women - 2/3 of seniors in hospital/Nursing Homes can’t walk w/o assistance Intrinsic Factors
Reasons Why Falls Occur Intrinsic FactorsExtrinsic Factors Normal Aging Changes Chronic & Acute Disease Medications FALLS
4+ prescriptions! Extrinsic Factors
Medications The big offenders - Sedative/hypnotics Depression/anxiety/mood-stabilizing medications - Heart, blood pressure, seizure, incontinence, other medications Extrinsic Factors
Reasons Why Falls Occur Intrinsic FactorsExtrinsic Factors Normal Aging Changes Chronic & Acute Disease Medications Environment Improper Use of Cane/Walker FALLS
Environment - Home hazards: bathrooms, stairs, clutter, throw rugs, lighting, sidewalks - "risky" behavior Improper use of cane/walker Extrinsic Factors
So What to Do? Falls: A Common Concern of Seniors
Screen for Risk Factors Do your own Home Safety Evaluation Evaluate your activity; Exercise Talk to your doctor So What to Do?
Nintendo Wii Golf So What to Do?
What your doctor will be thinking Join exercise program None Ask all >= 75+ 1 Fall or Balance/ Gait >= 2 Falls or Balance/ Gait Dx & Treat
FallsA Common Concern of Seniors We offer a complimentary fall-risk and/or home safety assessments to our managed care seniors. Please call our Wellness Center at 760-969-6550.
References Center for Disease Control and Prevention, National Center for Health Statistics, Health, United States, 2007. “Clinical Practice”. New England Journal of Medicine 2 January 2003:41-44. “What Causes Falls in the Elderly.” American Family Physician. 1 Apr. 2000. http://www.aafp.org/online/en/home.html