Assessment of Fall-Related Deaths and Hospitalizations for Hip Fractures among Older Adults

Stevens JA, Hasbrouck L, Durant TM, Dellinger AM, Batabyal PK, Crosby AE, Valluru BR, Kresnow M, Guerrero JL. Surveillance for Injuries and Violence Among Older Adults. In: CDC Surveillance Summaries, December 17, 1999. MMWR 1999;48(No. SS-8):27-50.

Researchers from CDC's National Center for Injury Prevention and Control (NCIPC) recently published an analysis of data on fall-related deaths from 1987-1996 and hospitalizations for hip fractures from 1988-1996 among adults 65 years and older in the United States. Analysis revealed that rates of fall-related deaths among older adults increased sharply with advancing age and were consistently higher among men in all age categories. Men were 22% more likely than women to sustain fatal falls. Researchers think this may be due in part to the higher prevalence of comorbid conditions (such as cardiovascular disease) among men than women of similar age.

A trend of increasing rates of all fall-related deaths was observed from 1987 through 1996.

Researchers believe this increase might reflect a change in the proportion of adults aged 85 years and older compared with those aged 65-84 years -- a change that results, in part, from reduced mortality from cardiovascular and other chronic diseases.

Hospitalizations for Hip Fractures

Hip fractures are one of the most serious outcomes associated with falls: half of all older adults who suffer these injuries never regain their former level of function. Data analysis showed that rates of hip fractures differed by age and were higher for white women than for white men, black women, and black men. Racial differences in hospitalization rates are thought to be due in part to the higher prevalence of osteoporosis, a condition that contributes to reduced bone mass and increased bone fragility, among older white women than white men, black women, and black men. From 1988 through 1996, U.S. hospitalization rates for hip fracture increased by 32% for women while the rates for men remained stable. Among adults 65 years and older, hip fracture hospitalization rates were roughly three times higher for women than for men. Women 85 years and older were almost 8 times more likely to be hospitalized for hip fractures than women 65-74 years old.

Implications for Prevention

Risk factors for fall-related deaths and injuries include both personal factors (such as neurologic and musculoskeletal disabilities, difficulties with gait and balance, use of psychoactive medications, and visual impairments) and environmental hazards (such as poor lighting, slippery surfaces, loose rugs, and other tripping hazards). The most effective fall prevention programs have reduced falls in select populations by 30%-50% by using a multifaceted approach that includes education, exercise (such as Tai Chi to improve strength, balance, and coordination), medication review, risk factor reduction, and home safety modifications. In addition to behavioral and environmental interventions to prevent falls, new approaches, including protective hip pads and impact-absorbing floor materials, offer promise to reduce the incidence of hip fractures among older adults.

Contact Information

For more information about this study, contact Judy Stevens, Ph.D., at the Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention, 770-488-4652, [email protected].