Falls - Ages 65+

Falls - Ages 65+ in United States

United States

Falls among older adults can lead to serious injuries, such as fractures, dislocations and traumatic brain injuries. Other potential consequences of falls include restricted activity, loss of independence and premature death. The fatality rate from falls has been increasing, particularly among those ages 85 and older. As the older adult population grows and lives longer, the number of falls is expected to increase.

Contributing factors for falls — and related injuries such as hip fractures — include poor balance, poor vision, certain medications, alcohol consumption, physical inactivity, osteoporosis, physical disabilities and general frailty.

Falls among older adults result in substantial medical costs. In 2015, the estimated medical costs attributable to fatal and nonfatal falls were approximately $50 billion. The average direct cost of fall injuries is $9,780 per non-fatal fall and $26,340 per fatal fall.

The prevalence of falls is higher among:

• Older women than older men.
• American Indian/Alaska Native, multiracial and white older adults compared with Asian older adults, who have the lowest prevalence of all racial and ethnic groups. 
• Older adults with an annual household income less than $25,000 compared with those with higher levels of income.
• Older adults living in non-metropolitan areas compared with those in metropolitan areas.

Actions older adults can take to prevent falls include:

• Talking with a doctor or pharmacist about medications that cause dizziness or drowsiness.
• Having annual eye exams and updating eyeglasses as needed.
• Getting screened for osteoporosis. 
• Participating in evidence-based programs, such as Tai Chi or A Matter of Balance, to improve balance and strength.
• Making the home environment safer by removing fall hazards and installing railings. Using non-skid shoes and depositing sand or salt on icy areas outside the home can also reduce fall risk.

Fall prevention education increases knowledge about avoiding falls and hip fractures and encourages older adults to stay active. The Centers for Disease Control and Prevention (CDC) has created the Stopping Elderly Accidents, Deaths and Injuries (STEADI) initiative to help health care providers make fall prevention routine. STEADI is based on clinical guidelines and provides information and resources for patients, caregivers and members of the health care team. 

The National Council on Aging offers a Falls Free CheckUp tool, which helps an individual identify their fall risk and provides resources and tools to reduce the risk.

Healthy People 2030 has two objectives related to falls among older adults: 

• Reducing fall-related deaths among older adults.
• Reducing the rate of emergency department visits due to falls among older adults.

Bergen, Gwen, Mark R. Stevens, and Elizabeth R. Burns. 2016. “Falls and Fall Injuries Among Adults Aged ≥65 Years — United States, 2014.” MMWR. Morbidity and Mortality Weekly Report 65 (37): 993–98. https://doi.org/10.15585/mmwr.mm6537a2.

Burns, Elizabeth R., Judy A. Stevens, and Robin Lee. 2016. “The Direct Costs of Fatal and Non-Fatal Falls among Older Adults — United States.” Journal of Safety Research 58 (September): 99–103. https://doi.org/10.1016/j.jsr.2016.05.001.

Florence, Curtis S., Gwen Bergen, Adam Atherly, Elizabeth Burns, Judy Stevens, and Cynthia Drake. 2018. “Medical Costs of Fatal and Nonfatal Falls in Older Adults.” Journal of the American Geriatrics Society 66 (4): 693–98. https://doi.org/10.1111/jgs.15304.

Garnett, Matthew. 2020. “QuickStats: Death Rates from Unintentional Falls Among Persons Aged ≥65 Years, by Age Group — National Vital Statistics System, United States, 1999–2018.” MMWR. Morbidity and Mortality Weekly Report 69 (45): 1712. https://doi.org/10.15585/mmwr.mm6945a10.

Haddad, Yara K., Iju Shakya, Briana L. Moreland, Ramakrishna Kakara, and Gwen Bergen. 2020. “Injury Diagnosis and Affected Body Part for Nonfatal Fall-Related Injuries in Community-Dwelling Older Adults Treated in Emergency Departments.” Journal of Aging and Health 32 (10): 1433–42. https://doi.org/10.1177/0898264320932045.

Matsuda, Patricia Noritake, Aimee M. Verrall, Marcia L. Finlayson, Ivan R. Molton, and Mark P. Jensen. 2015. “Falls Among Adults Aging With Disability.” Archives of Physical Medicine and Rehabilitation 96 (3): 464–71. https://doi.org/10.1016/j.apmr.2014.09.034.