A new study revealed that despite prevention efforts, falls in older adults have increased by about 1.5% annually, with wide variations in incidence based on geography. And this data does not even account for a greater prevalence of falls and related injuries in older people due to COVID-19-related restrictions, which increased sedentary behavior and physical inactivity.
“It could be that efforts aren’t working — or that they are, by mitigating even worse potential injury risk in the population,” said Geoffrey Hoffman, assistant professor at the University of Michigan School of Nursing and co-author of the research letter, which appears in JAMA Network Open. “Either way, more investment in prevention, such as education and funding for fall education and prevention programs would help.”
For this study, 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.
However, it’s not clear why falls are increasing, according to Hoffman. Changes in health and function, medication prescribing patterns, or even a more active older population could all contribute to increased falls. The findings could also reflect other changes in treatment and care or how fall injuries are administratively coded.
In a statement, Hoffman said he 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, according to Hoffman.
Higher-risk areas were in the Central Plains and South. However, these areas are less populated so data is sparser and potentially less reliable. While the geographic variability among low and high areas was surprising, the overall findings were not, Hoffman said.
“Severity of illness is increasing among Medicare beneficiaries, with older individuals living longer. So, there is a shift in demographics, plus changes in enrollment trends,” he said. “We also have insurance-related limitations. Medicare covers treatment for injury, but not for long-term care that may help maintain function in older individuals, so it’s difficult to mitigate these risks.”
As this new tip sheet explains, 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.
The new tip sheet provides links to relevant research, experts to call, resources and more to help you cover this ongoing story .
