Statement on older adult falls and falls prevention

The following statement was developed by the American College of Surgeons (ACS) Committee on Trauma and was approved by the Board of Regents at its June 6–7 meeting.

The following statement was developed by the ACS Committee on Trauma’s Committee on Injury Prevention and Control to educate surgeons and other medical professionals about the significance of older adult falls and evidence-based prevention activities.

The ACS recognizes the following facts:

  • Falls are the leading cause of both fatal and nonfatal injuries for older adults.1
  • One out of three older adults falls each year. Of these, fewer than half talk to their health care providers about it.2
  • Many people who fall, even if they are not injured, develop a fear of falling, which may cause them to limit activities, leading to reduced mobility, loss of physical fitness, and, in turn, an increased risk of falling.3,4
  • A person who has fallen once is two to three times more likely to fall again within a year.5

The ACS supports efforts to promote, enact, and sustain legislation and policies that encourage:

  • Older adult care providers to implement comprehensive fall prevention programming including:
    • Developing community partnerships with community-based centers, such as YMCAs, churches, senior centers, and older adult living centers.
    • Incorporating an evidence-based exercise/physical therapy fall prevention program. Helpful information can be found at the CDC and other websites.
    • Partnering with home-based visiting programs to complete multi-factorial risk assessments, including: medication review, including the use of opioids; assessment of vision, home safety, and balance and gait; and consideration of vitamin D supplementation.
  • Assessment of the risk/benefit of anticoagulation and anti-platelet therapies in older adult patients.
  • Risk assessment of falls in regular practice. Examples are included in the STEADI (Stopping Elderly Accidents, Deaths, and Injuries) tool kit.
  • Collaboration with regional and statewide fall prevention coalitions for local networking/resources.

References

  1. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS). Available at: http://www.cdc.gov/injury/wisqars. Accessed August 15, 2013.
  2. Stevens JA, Ballesteros MF, Mack KA, Rudd RA, DeCaro E, Adler G. Gender differences in seeking care for falls in the aged Medicare population. Am J Prev Med. 2012;43(1):59-62.
  3. Bell AJ, Talbot-Stern JK, Hennessy A. Characteristics and outcomes of older patients presenting to the emergency department after a fall: A retrospective analysis. Med J Aust. 2000;173(4):176-177.
  4. Roudsari BS, Ebel BE, Corso PS, Molinari, NM, Koepsell TD. The acute medical care costs of fall-related injuries among the U.S. older adults. Injury. 2005;36(11):1316-1322.
  5. Ganz DA, Bao Y, Shekelle PG, Rubenstein LZ. Will my patient fall? JAMA. 2007;297(1):77-86.

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