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More elderly Americans dying from falls

(Reuters Health) – Death rates from falls are rising among elderly Americans – and climbing fastest among seniors in their 90s, a U.S. study suggests.

Among all adults 75 and older, mortality from falls climbed 5.1 percent from 2000 to 2016, researchers report in JAMA. Death rates from falls rose the most – 6.4 percent – among people 95 and up.

“People can die after a fall for many reasons, which may include head trauma, internal bleeding, and complications of a bone fracture,” said study co-author Dr. Robin Lee of the U.S. Centers for Disease Control and Prevention in Atlanta.

“The latter may lead to hospitalization, immobility in bed, and respiratory or other infections, which can be fatal,” Lee said by email.

Falls are the leading cause of both traumatic brain injury and hip fractures, and more than half of hip fractures prove fatal within one year, Lee said.

Many older adults may also be taking medications with side effects that can increase the risk of falling such as vision impairment, confusion, and sleepiness, Lee added.

The “oldest old” may be most at risk, the study findings suggest.

In 2016, there were roughly 591 deaths from falls for every 100,000 people 95 and older, compared with 42 for every 100,000 people ages 75 to 79.

Overall, the absolute number of deaths from falls among U.S. adults aged 75 or older rose from 8,613 in 2000 to 25,189 in 2016.

The risk of fatal falls rose more sharply for women, with the rate climbing from 46.3 to 105.9 per 100,000 women, whereas it rose from 60.7 to 116.4 per 100,000 men.

The study wasn’t designed to prove whether or how certain factors cause falls to be fatal.

One limitation of the study is that it was based on information from the U.S. Census Bureau, which might undercount people 65 and older, resulting in an overestimation of death rates, the study authors note.

The researchers also couldn’t tell whether people in the study fell more than once, or whether they had fall-related fractures, said Dr. Marco Pahor, author of an accompanying editorial and director of the Institute on Aging at the University of Florida in Gainesville.

“Falls can be prevented,” Pahor said by email.

“Several steps can be taken to minimize the risks of falling and related injuries, including weight bearing exercises, such as walking, balance exercises, resistance exercises to strengthen muscles, prevention and treatment of osteoporosis, review of medications that may cause (low blood pressure) or loss of balance, correction of vision impairments, correction of foot problems or unsafe footwear, and correction of any home safety issues,” Pahor advised.

SOURCE: JAMA, online June 4, 2019.

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