For millions of older Americans, falls present a serious health risk. In the United States, one of every three people 65 and older falls each year. Among older adults, falls are the leading cause of injury deaths and the most common cause of injuries and hospital admissions for trauma. In 1997, about 9,000 seniors died of fall-related injuries. The total direct cost of fall injuries in 1994 among people 65 and older was $20.2 billion. And the number of people over age 65 is expected to increase from 31 million in 1990 to 68.1 million by 2040.

Also in this article: How Serious Is the Problem? What Other Health Outcomes Are Linked With Falls? Where Are People Most Likely to Fall? What Is the Effect of Hip Fractures? What Factors Increase Older Adults' Risk of Falling? What Can Older Adults Do to Reduce Their Risk of Falling?

Fractures are the most serious health consequence of falls. Eighty-seven percent of all fractures among older adults are due to falls. Approximately 250,000 hip fractures, the most serious fracture, occur each year among people over 65. Half of all older people hospitalized for hip fractures cannot return home or live independently after their injury.

Many of these falls and resulting injuries can be prevented. Strategies to prevent falls among older adults include exercises to improve strength, balance and flexibility; reviews of medications that may affect balance; and home modifications that reduce fall hazards such as installing grab bars, improving lighting and removing items that may cause tripping.

How Serious Is the Problem?

• In the United States, one of every three adults 65 or older falls each year.
• Falls are the leading cause of injury deaths among people 65 and older.
• In 1998, about 9,600 people over the age of 65 died from fall-related injuries.
• Of all fall deaths, more than 60 percent involve people who are 75 or older.
• Fall-related death rates are higher among men than women and differ by race. White men have the highest death rate, followed by white women, black men and black women.

What Other Health Outcomes Are Linked With Falls?

• Among older adults, falls are the most common cause of injuries and hospital admissions for trauma.
• Falls account for 87 percent of all fractures for people 65 years and older. They are also the second leading cause of spinal cord and brain injury among older adults.
• Each year in the United States, one person in 20 receives emergency department treatment because of a fall. Advanced age greatly increases the chance of a hospital admission following a fall.
• Among older adults, fractures are the most serious health outcomes associated with falls. About 3 percent of all falls cause fractures.8 The most common are fractures of the pelvis, hip, femur, vertebrae, humerus, hand, forearm, leg and ankle.

Where Are People Most Likely to Fall?

For adults 65 or older, 60 percent of fatal falls happen at home, 30 percent occur in public places, and 10 percent occur in health care institutions.

What Is the Effect of Hip Fractures?

• Of all fractures from falls, hip fractures cause the greatest number of deaths and lead to the most severe health problems.
• In 1996, there were approximately 340,000 hospital admissions for hip fractures in the United States.
• Women sustain 75 percent to 80 percent of all hip fractures.
• People 85 or older are 10 to 15 times more likely to experience hip fractures than are people 60 and 65.
• Most patients with hip fractures are hospitalized for about two weeks.
• Half of all older adults hospitalized for hip fractures cannot return home or live independently after their injuries.
• In 1991, Medicare costs for hip fractures were estimated to be $2.9 billion.
• Because the U.S. population is aging, the problem of hip fractures will likely increase substantially over the next four decades. By 2040, the number of hip fractures is expected to exceed 500,000.

What Factors Increase Older Adults' Risk of Falling?

Factors that contribute to falls include problems with gait and balance, neurological and musculoskeletal disabilities, psychoactive medication use, dementia, and visual impairment.

Environmental hazards such as slippery surfaces, uneven floors, poor lighting, loose rugs, unstable furniture, and objects on floors may also play a role.

What Can Older Adults Do to Reduce Their Risk of Falling?

• Maintain a regular exercise program. Exercise improves strength, balance, and coordination.
• Take steps to make living areas safer. Remove tripping hazards and use non-slip mats in the bathtub and on shower floors. Have grab bars put in next to the toilet and in the tub or shower, and have handrails put in on both sides of all stairs.
• Ask their doctor to review all of their medicines to reduce side effects and interactions.
• Have an eye doctor check their vision each year. Poor vision can increase the risk of falling.