For older adults, falls and associated injuries threaten health, independence, and quality of life. More than a third of people aged 65 years and older who live independently fall each year; falls are the leading cause of injury-related deaths and hospital emergency department visits.
While numerous fall risk factors have been identified, limited information is available about the detailed circumstances surrounding falls among community-dwelling older adults. Several studies have used survey data to analyze falls, while other studies have limited their analysis to falls seen in emergency departments, in older women, or falls that resulted in fracture or hip fracture.
More than 6.8 million injury episodes for which people sought medical treatment were self-reported by individuals in 2012. The majority of injuries occurred to people between the ages of 18 and 64 years, the ages that comprised 83% of the over-18-year population in the United States. Sprains and strains was the most frequent injury type for which medical care was sought, but 16% suffered fractures, 14% severe contusions, and 13% open wounds.
Falls are the primary cause of musculoskeletal injuries as the population ages. Approximately three out of four injuries among people aged 85 years and older for which a person is hospitalized or visits an emergency department is the result of a fall. Falls are also the primary cause of injury for anyone aged 65 years and older. Trauma such as auto accidents and other accidents involving machinery or moving objects is a major cause of musculoskeletal injuries among people ages 45 to 64 years, particularly for injuries where care is received in an emergency department. Other causes of injuries, including sports injuries, are seen in more than one in four (28%) injuries to people aged 45 to 64 years with a hospital discharge. (Reference Table 9B.6.1 PDF [1] CSV [2] and Table 9B.6.2 PDF [3] CSV [4])
In 2011, 1.6 million hospital discharges and 14.7 million emergency department visits were made by people aged 18 years and older for treatment of a musculoskeletal injury. Another 35.5 million musculoskeletal injuries were serious enough to receive outpatient treatment. The most frequent type of injury involving hospitalization was a fracture, with people aged 85 years and older accounting for 45% of hospitalizations for fractures. Injuries seen in emergency departments were distributed across all types of musculoskeletal injuries (fractures, dislocations, sprains and strains, contusions, open wounds, and other types of musculoskeletal injuries). The youngest and oldest age groups (18 to 44 years and 85 years and older) had the highest rate of injury seen in the ED (6.9/100 persons and 9.9/100, respectively). Because of the large size of the 18- to 44-year age group (48% of the US population is over age 18), this group constituted a majority of all injury cases seen, with the exception of fractures. (Reference Table 9B.6.2 PDF [3] CSV [4] and Table 6A.2.2.2 PDF [5] CSV [6])
For all types of musculoskeletal injuries resulting in hospitalization, three of four people ages 85 years and older were discharged to intermediate-term nursing care, while two in three aged 75 to 84 years went to nursing care. Fractures were the most likely type of injury to result in discharge to intermediate-term nursing care for all ages, followed by dislocations. (Reference Table 9B.6.3 PDF [7] CSV [8])
Discharge to intermediate-term or skilled nursing care greatly increases the economic burden of musculoskeletal injuries. In 2011, 40% of hospital discharge patients with a musculoskeletal injury, or 690,000, were sent to long-term or skilled nursing facilities.
Links:
[1] https://bmus.latticegroup.com/docs/T9B.6.1.pdf
[2] https://bmus.latticegroup.com/docs/T9B.6.1.csv
[3] https://bmus.latticegroup.com/docs/T9B.6.2.pdf
[4] https://bmus.latticegroup.com/docs/T9B.6.2.csv
[5] https://bmus.latticegroup.com/docs/T6A.2.2.2.pdf
[6] https://bmus.latticegroup.com/docs/T6A.2.2.2.csv
[7] https://bmus.latticegroup.com/docs/T9B.6.3.pdf
[8] https://bmus.latticegroup.com/docs/T9B.6.3.csv