Americas Falling Epidemic

Why Does America's Falling Epidemic

Keep Getting Worse?

The risk of dangerous falls is increasing for Americans over the age of 65. Factors such as distractions, a lack of physical activity, and ill-fitting shoes can all contribute to this issue.

More than 1 in 4 individuals over the age of 65 experience a fall each year. Earlier this month, veteran TV host and comedian Jay Leno became one of them. At 74, Leno left his hotel near Pittsburgh in search of a meal. To shorten the distance to the restaurant, he took a shortcut down a grassy hill. Unfortunately, he fell on the slope, resulting in a broken wrist and substantial bruising to his face and the entire left side of his body.

Leno still managed to perform his comedy act that night, making him luckier than many who suffer from falls. Each year, falls among older Americans lead to approximately 3.6 million emergency room visits and 1.2 million hospital admissions, costing around $80 billion. According to the Centers for Disease Control and Prevention, 41,000 senior citizens die from falls annually. In recent years, notable individuals such as comedian Bob Saget, former Connecticut Senator Joe Lieberman, and Ivana Trump have died as a result of falls.

Despite advancements in care and prevention techniques, a study from the University of Michigan revealed that the number of falls increases by approximately 1.5% each year. "It could be that current efforts aren't effective, or they might be working by reducing the risk of even more severe injuries in the population," said Geoffrey Hoffman, a gerontologist at the University of Michigan. "In either case, increasing investment in prevention and funding for fall education and prevention programs would be beneficial."

The CDC runs a program called STEADI (Stopping Elderly Accidents, Deaths, and Injuries) to help healthcare providers screen older patients for fall risk factors. These factors include a history of falls, vision issues, insufficient vitamin D intake, and foot problems. One common test involves having the patient rise from a chair, walk 10 feet, turn around, walk back, and sit down. If this process takes longer than 12 seconds, the patient is considered at risk for a fall.

Earlier this year, Representative Carol Miller of West Virginia, a Republican, introduced legislation aimed at incorporating fall-risk assessments into Medicare's annual wellness benefit for all seniors. The bill, referred to as the SAFE Act, would also require the Department of Health and Human Services to provide Congress with annual statistics regarding falls.

"I'm a senior myself," Miller told me shortly after her 74th birthday. "You fall, you hurt yourself, and then you end up in the hospital. I had a neighbor who recently fell off a ladder in the kitchen and injured their head and hip, and they're still in the hospital. It's a tough situation. Americans are aging!"

CDC data reveal significant disparities among states regarding the frequency of falls among seniors. In Alaska, over 38% of seniors experience falls each year, followed closely by South Dakota at 34%. When considering the risk of death from falls, Wisconsin has the highest rate, with 176 fatalities annually per 100,000 residents aged 65 and older. Minnesota and South Dakota follow with a rate of 140. On the other hand, Illinois reports the lowest incidence of falls at 20%, with Connecticut and Hawaii slightly higher at 21%.

Jennifer Vincenzo, a professor of physical therapy at the University of Arkansas who researches falls among older Americans, observes that "the states with the lowest levels of physical activity have the highest rates of falls. If people engage in more activity, they may have a lower risk."

Nationally, the death rate from falls increased by 41% from 2012 to 2022, the most recent period for which statistics are available. Among seniors, the factors contributing to falls are frustratingly complex. Reactions to prescription medications, impaired vision, and even basic issues like loneliness or ill-fitting shoes often elevate the risk of falling.

Vincenzo notes, "Research has also been conducted on dual tasks, such as multitasking. It becomes difficult to concentrate on movement when you're also engaged in another activity, like talking on the phone or texting. If you have balance or walking issues, you're less likely to pay attention to them, which could increase the risk of falling."

The National Council on Aging recommends that older Americans complete a free online risk survey. Seniors should also evaluate their medications for potential effects on stability, consider obtaining a medical alert device if budget allows, and develop a home safety checklist. This checklist may include removing small throw rugs, adding a night-light in the bathroom, avoiding shelves that are too high to reach safely, and installing grab bars.

Vincenzo's research shows that only half of older adults adhere to recommendations following a fall-prevention screening. Unsurprisingly, she discovered that those who did not follow the recommendations experienced higher rates of falls.

Many falls among older Americans go unreported, but documented incidents total approximately 14 million each year. One case involved a 75-year-old woman in Salinas, California, who fell in her bedroom last June and remained on the floor, unable to stand, until her son arrived for a visit about 16 hours later. After a lengthy hospital stay, her family acquired a monitoring device from Lifeline, a medical alert company, which is one of several firms in what has become a $4 billion industry.

On November 8, the woman fell again, resulting in a severely fractured arm. This time, the device she was wearing around her neck detected the fall and automatically sent a message to a dispatcher via a landline. Within seconds, the dispatcher's voice came through a speaker, addressing the woman by her first name. A fire department rescue unit was notified, and responders were able to enter the house using a key stored in a lockbox, which was provided as part of Lifeline's $48 monthly service.

"It's been a literal lifesaver," said the woman, who lives alone after her husband's death. Lifeline has now launched a "totally wireless" option that enables users to utilize the fall detection system anywhere in the U.S. The market for stand-alone, mobile, and landline medical alert systems is projected to reach $4.6 billion next year, indicating an annual growth rate of over 12%.

After his recent fall, Jay Leno used some self-deprecating humor, saying, "The great thing about this age is you don't learn from your mistakes; you just keep doing the same stupid thing." This is precisely what healthcare experts aim to change through education, testing, and behavior modification. As Vincenzo cautions, "The highest risk factor for having a fall is having had a fall."