Falls in Older Adults, New York State

The Concern

Falls are the leading cause of injury deaths, hospitalizations and emergency department visits among adults 65 and older. Falls can result in lasting, serious consequences, affecting mobility, independence and mental health.

Falls are not accidents! They are not random, uncontrollable acts of fate, but occur in predictable patterns, with recognizable risk factors and among identifiable populations. A fall is a predictable and preventable event.

Magnitude of the Falls Problem

  • Every day, because of a fall:
    • 2 older New Yorkers die
    • 136 older New Yorkers are hospitalized
    • 215 older New Yorkers are seen in Emergency Departments (ED)
  • Falls account for $1.5 billion in annual hospitalization charges and $123.5 million in annual outpatient emergency department changes.
  • 60.0% of adults 65 and older who are hospitalized due to a fall end up in a nursing home or rehabilitation center
  • Among adults 65 and older who are hospitalized due to a fall, 10.8% suffer a traumatic brain injury and 28.4% experience a hip fracture
  • Fall injuries among older adults in New York State are increasing!
    • From 2001 to 2007:
      • Rate of fall-related deaths increased 13%
      • Rate of fall-related hospitalizations increased 15%

Fall Injuries, Yearly Average Number of New York State Residents Ages 65 and Older, 2005-2007

Result of Fall Injuries Number of Injuries
Death 894
Hospitalizations 49,719
Outpatient Emergency Department Visits 78,555
Other medical Teatment or Untreated Unknown Number

Deaths Due to Falls, New York State Residents Ages 65 and Older, 1999-2007

Year Annual Frequency Rate per 100,000
1999 771 31.7
2000 764 31.1
2001 787 31.9
2002 858 34.7
2003 874 35.2
2004 865 34.6
2005 933 37.1
2006 834 33.1
2007 914 35.9

Hospitalizations Due to Falls, New York State Residents Ages 65 and Older, 1999-2007

Year Annual Frequency Rate per 100,000
1999 41,443 1,705.7
2000 42,567 1,735.4
2001 42,367 1,719.9
2002 43,351 1,750.9
2003 47,358 1,904.6
2004 48,030 1,920.3
2005 48,947 1,946.2
2006 49,837 1975.6
2007 50,372 1978.2

Many Falls are the Result of Multiple Risk Factors Working in Concert

Who is at Risk?

  • Males have a higher risk of death due to falls
  • Females have a higher risk of hip fracture due to falls
  • Aging increases the risk of falling and the severity of a fall injury
  • People who have previously fallen are at an increased risk to fall again
  • People who suffer from sleep disturbances are at an increased risk of falling

What Conditions Increase the Risk of Falling?

  • Leg weakness is associated with a four-fold increase in the risk of falling
  • Problems with gait and balance are associated with a 3-fold increase in the risk of falling
  • Vision impairment increases the risk of falling by 2.5 times
  • Chronic conditions such as Parkinson's disease, stroke, arthritis, osteoporosis and incontinence increase the risk of falling
  • A fear of falling leads to loss of confidence, an avoidance of physical activity, an increased functional decline, and ultimately an increased risk of falling
  • Taking four or more medications puts older adults at risk for falling

Where is the Risk?

  • Over 50% of fall-related hospitalizations in older adults occur in the home
  • Almost 1/3 of fall-related ED visits in older adults occur in the home

Place of Fall, New York State Residents Ages 65 and Older, 2005-2007

Hospitalizations

Place Percentage of Fall-Related Hospitalizations
Home 52%
Street and Highway 7%
Public Building 2%
Residential Institution 15%
Other 10%
Unspecified 14%

ED Visits

Place Percentage of Fall-Related ED Visits
Home 30%
Street and Highway 10%
Public Building 3%
Residential Institution 8%
Other 16%
Unspecified 33%

Home Hazards Include:

  • Clutter in walkways and on stairs
  • Slippery or inconsistent flooring surfaces
  • Unstable furniture
  • Poor / inadequate lighting
  • Pets and pet-related objects
  • Lack of stair railings or grab bars
  • Lack of easy access bathrooms

Prevention Strategies

What reduces the risk of falling?

  • Medication review
  • Home assessments with modification
  • Exercise
  • Annual vision exams

Falls are the leading cause of injury among New Yorkers over 65 - they CAN be prevented!

For more information on fall prevention please contact:

Your health care provider is also an excellent resource about fall injuries and prevention. Web resources include: