Why Does America's Falling Epidemic Keep Getting Worse?
Falling | Health | Seniors | Aging | May 7, 2025
This Week's Quote: "The sun himself is weak when he first rises and gathers strength and courage as the day gets on."
- Charles Dickens
More than 1 in 4 people over age 65 fall each year. Earlier this month, the veteran TV host and comedian Jay Leno was one of them. Leno, 74, left his hotel near Pittsburgh looking for a bite to eat. It would have been a long walk to the restaurant, so he took a shortcut down a grassy hill. A tumble on the slope left him with a broken wrist and significant bruises to his face and entire left side.
Leno still managed to do his comedy act that night. He was luckier than many fall victims. Every year, falls among older Americans result in about 3.6 million emergency room visits and 1.2 million hospital stays, at a cost of roughly $80 billion. Nationwide, 41,000 senior citizens die from falls annually, according to the Centers for Disease Control and Prevention. In recent years, prominent figures such as comedian Bob Saget, former Connecticut Sen. Joe Lieberman and Ivana Trump died after a fall.
And despite progress in care and prevention techniques, a University of Michigan study found that the number of falls goes up about 1.5% every year. “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, a gerontologist at the University of Michigan. “Either way, more investment in prevention and funding for fall education and prevention programs would help."
The CDC operates a program known as STEADI (Stopping Elderly Accidents, Deaths and Injuries) to assist healthcare providers in screening older patients for fall risk factors, such as a history of falls, vision problems, inadequate vitamin D intake and foot problems. In one common test, the patient must get up from a chair, walk 10 feet, turn around, walk back and sit down. If this takes more than 12 seconds, they are deemed to be at risk for a fall.
Earlier this year, Rep. Carol Miller of West Virginia, a Republican, introduced legislation to make fall-risk assessment part of Medicare’s annual wellness benefit for all seniors. The bill, known as the SAFE Act, would also direct the Department of Health and Human Services to report annual statistics about falls to Congress.
“I’m a senior myself,” Miller told me soon after her 74th birthday. “You fall, you hurt yourself, you go to the hospital. I had a neighbor who recently fell on a ladder in the kitchen and hit their head and their hip, and they’re still in the hospital. It’s a tough thing. Americans are aging!”
CDC data show a wide disparity among states in terms of frequency of falls. In Alaska over 38% of seniors suffer falls each year, with South Dakota next at 34%. When it comes to the risk of death from falling, Wisconsin has the highest rate, with 176 fatalities annually per 100,000 residents over age 65.
Minnesota and South Dakota are next, at 140. Illinois has the lowest incidence of falls at 20%, followed by Connecticut and Hawaii at 21%.
Jennifer Vincenzo, a professor of physical therapy at the University of Arkansas who studies falls among older Americans, notes that “the states with the lowest level of physical activity have the worst rates of falls. If people are doing more activity, they potentially will be at a lower risk.”
Nationally, the death rate from falls jumped 41% from 2012 to 2022, the latest period for which statistics are available. Among seniors, the contributing factors for falls are frustratingly complex. Reaction to prescription drugs, impaired vision and even such basic things as loneliness or ill-fitting shoes often add to the risk of falling.
“There has also been research on dual tasks, like doing more than one thing at a time,” Vincenzo notes. “It’s hard for you to focus on movement if you’re focusing on doing another task, talking on the phone or texting, so that if you have impaired balance or walking problems, you’re not going to pay attention to that and potentially fall.”
The National Council on Aging advises older Americans to take a free online risk survey. Seniors should also review medications with regard to possible impact on stability, acquire a medical alert device if affordable, and create a home safety checklist, which can include getting rid of small throw rugs, adding a bathroom night-light, avoiding shelves that are too high to reach safely and installing grab bars.
Vincenzo’s studies indicate that only half of older adults follow recommendations after getting a fall-prevention screening. Predictably, she found that those who didn’t suffered higher rates of falls.
Many falls among older Americans go unreported, but documented incidents total about 14 million a year. One case involved a 75-year-old woman in Salinas, Calif., who fell in her bedroom last June and remained on the floor, unable to stand, until her son arrived for a visit some 16 hours later.
Following a lengthy hospital stay, her family got her a monitoring device from the medical alert company Lifeline, one of several firms in what has become a $4 billion industry.
On Nov. 8, the woman fell again, leaving her with a severely fractured arm. This time the device she was wearing around her neck sensed the fall and automatically triggered a message to a dispatcher via telephone landline. Within seconds, the dispatcher’s voice came through a speaker, addressing the woman by her first name. A fire department rescue unit was contacted and responders were able to enter the house using a key in a lockbox, supplied as part of Lifeline’s $48 monthly service.
“It’s been literally a life saver,” said the woman, who lives alone following her husband’s death. Lifeline has now introduced a “totally wireless” option that allows users to use the fall detection system anywhere in the U.S. The market for stand-alone, mobile and landline medical alert systems is expected to increase to $4.6 billion next year, reflecting annual growth of more than 12%.
Turning to a bit of self-deprecating wit following his recent fall, Jay Leno quipped, “The great thing about this age is you don’t learn from your mistakes, you just keep doing the same stupid thing.” That’s exactly what healthcare experts hope to change through education, testing and behavior modification.
As Vincenzo warns, “The highest risk factor for having a fall is having had a fall.”
Credit goes to Peter Funt, published in Wall Street Journal, November 27, 2024
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This Week’s Author, Mark Bradstreet