Falling becomes a much greater concern as you age. Though children and perhaps even young adults are used to falling and getting right back up, the latter becomes much more difficult as you grow older. Since the body naturally declines in its physical condition, you must get familiar with the possible consequences that a mere trip and fall can impose on your life.
The most common consequences that older individuals experience after a fall are fractures, bruising, soft tissue injuries, functional decline, and psychological impacts such as lowered confidence and an unwillingness to engage in physical activities. Other injuries that can arise include lacerations, sprains, and dislocations.
To protect yourself or your loved one, you must learn the risk factors that can lead to an accidental fall, the most common causes of these accidents, and how to prevent them. You don’t want to take the trial-and-error route by learning this on your own. Instead, see the overview below for more information on this issue and how to prevent you or your loved one from becoming a victim.
The Facts on Falling for Older People
Although most people would be confused by the idea of there being “consequences” to falling, millions of maturing individuals must consider this danger with each passing day. In fact, the issue is so severe for older demographics that the World Health Organization (WHO) has declared falls to be the “second leading cause” of accidental injuries and deaths throughout the world.
Seniors above the age of 65 years old are most often affected by the risks of falling. However, in total, WHO estimates that 646,000 people die each day from fatal falls, the vast majority of which (80%) come from impoverished or underprivileged countries.
In a legal and medical context, WHO defines a fall as an event in which someone unintentionally ends up “coming to rest” on a surface that is lower than that which they were initially standing on. Although these incidents can take someone’s life, they are – thankfully – most often, non-fatal. Still, they are considered one of the most significant public health crises worldwide (WHO).
Falls can affect people of all ages, from children to the elderly. However, your age may be a contributing factor to your vulnerability to the consequences of falling. See the next section for more information on the risk factors that may increase the probability of injury or death from a fall.
Contributing Risk Factors for Falling
Although just about anyone can find themselves hurt after a major fall, there are a few things that can make the incident much worse than you might expect. Two of the most prominent contributing factors that can worsen the outcome of a fall include:
- Age: Older individuals face significantly higher risk levels for falling than any other demographic. Not only does the possibility of incurring a serious injury rise with age, but the likelihood of death grows as well. WHO experts believe that this increase in danger is attributed to the natural changes associated with aging, such as physical and sensory decline.
- Note: Keep in mind that your elders are not the only ones at risk of experiencing this trauma, as children are also a high-risk demographic. This is because they are more inclined to engage in hazardous behaviors, especially when unsupervised. Still, in the United States, 20-30% of older individuals incur the injuries listed below from accidental falls:
- Bruises
- Fractures, especially affecting the hips
- Traumatic head injuries
- Note: Keep in mind that your elders are not the only ones at risk of experiencing this trauma, as children are also a high-risk demographic. This is because they are more inclined to engage in hazardous behaviors, especially when unsupervised. Still, in the United States, 20-30% of older individuals incur the injuries listed below from accidental falls:
- Gender: No matter the demographic or geographic region, all genders face similar risk levels of experiencing a dangerous fall. However, experts note that these incidents most often result in death for males, and females are more likely to experience minor to severe injuries instead. According to WHO, the risk factors that may explain these disparities include:
- Unsafe or otherwise dangerous work environments
- Abuse of alcohol or drugs
- Economic challenges, poor housing conditions, and related socioeconomic problems
- Pre-existing medical issues and compounding side effects from prescribed medication
- Physical, psychological, and sensory challenges related to medical complications
Common Causes of Falling for Older People
For a thorough understanding of the effects of dangerous falls, you will first need to understand the causes behind these incidents. For older people specifically, falls are more likely to occur as a result of the following ( Royal College of Nursing):
- A history of one or more falling events
- Weak muscles resulting from medical conditions or previous injuries
- Impaired balance
- Complications with vision
- The simultaneous use of several medications
- Note: The Centers for Disease Control and Prevention (CDC) and other research teams have connected the use of the following medication types to the increased risk of falling ( CDC; U.S. National Library of Medicine):
- Anticonvulsants
- Antidepressants
- Neuroleptics and antipsychotics
- Benzodiazepines
- Opioids
- Sedatives, including antihistamines, muscle relaxants, blood pressure medications, and anticholinergics
- Note: The Centers for Disease Control and Prevention (CDC) and other research teams have connected the use of the following medication types to the increased risk of falling ( CDC; U.S. National Library of Medicine):
Whether you live with one or more of these potential risk factors, there is a myriad of consequences that you might experience after an accidental fall. The most common types of effects that result from these incidents are discussed below.
Hip Fractures from Falling
One of the most common issues that fall victims suffer from is a hip fracture. According to Age UK, the National Health Service (NHS) reported almost 100,000 hip fractures in people ages 65 and older throughout 2017-2018. Although many of these events are preventable, they often end up with severe consequences, especially for individuals older than 75 years old.
Reports showed that more than 5,000 people in this age bracket died because of a fall in 2017 alone. These estimates represented a 70% rise in these types of fatal accidents since 2010. Referring to the disparities in gender regarding fall risk, NHS data shows that over two-thirds of reported hip fractures as a result of falling occur in women (Age UK).
This is only one of the many factors that make falling significantly more of a concern for women (45%) than men (26%). However, gender does not act alone as a contributing factor to the likelihood of a fall. Researchers have stated that these incidents are “multifactorial,” and are influenced by these additional elements (U.S. National Library of Medicine):
- Fall descent: This refers to the specifics of how the individual fell. For example, if you have slow reaction time or sustain a week grip on nearby handholds, you are likely to experience a minor injury. However, if you fall from a greater height, you may suffer more severe wounds. The person’s height and the direction of the fall also contribute to the consequences’ severity.
- Fall impact: The site and strength of the fall’s impact is a direct contributor the severity of the resulting injuries and likelihood of death. For instance, if you were to fall directly onto your bottom, you are less likely to suffer from a fracture because of all the soft tissue. The surface you fall on plays a significant role as well, as harder surfaces may cause more severe harms.
- Bone strength: When the force of the fall outweighs the bones’ strength, fractures are far more likely to occur. Deficiencies in calcium and vitamin D may increase the probability of a fracture, as these minerals are crucial to the bone mineral density (BMD).
Additional Types of Physical Consequences of Falling
Researchers have developed four primary categories of physical fall injuries. These designations are largely determined by the severity and specific effects of the wound. (They also added a “bonus” category, per se, that addresses the deeper, physiological impacts of a fall.) The four main types of physical consequences are discussed below. (European Review of Ageing and Physical Activity)
Fractures as a Result of Falling
Hip fractures, addressed above, are one of the many fracture types that you might experience from a fall as an older individual. Though the hips are most often affected, breaks can occur anywhere in the body and cause a wide range of acute or long-lasting health effects.
Apart from broken hips (which account for 37.9% of fall-related fractures), research has covered the following fracture types as primary concerns for fall risk in older demographics:
- Undifferentiated bone fractures (27.5%)
- Broken femur (5.7%)
- Fractures occurring on the trunk (casually known as the “torso,” 4.5%), neck (4.5%), and chest (1.1%)
- Broken arms (3.4%), especially the humerus (2.2%)
- Broken knees (1.1%)
Different Types of Bruises Caused by Falling
Of course, any part of your body that has blood vessels flowing through it can bruise. However, the type that is most well-known in scientific literature is the “head bruise.”
This often refers to contusions or hematomas, where the blood begins to accumulate between the skull and brain, or visible bruising around the eyes or behind the ear. All these are signs of severe head injury and require immediate medical attention. These types of injuries occurred in just slightly more than 10% of falls; yet, this does not take away from the significance of such consequences. (NHS; NHS)
Other types of bruising occur alongside abrasions (wounds that break the skin) and may lead to blood loss in the form of a hematoma or hemorrhage.
Injuries Resulting from Falls
Researchers do not necessarily consider the above physical consequences to be “injuries,” in the most common sense of the word. Instead, they categorize many miscellaneous types of physical effects as an injury, including:
- Soft tissue injuries (6.8%)
- Wounds affecting the upper extremities (5.7%)
- Elbow wounds (2.2%)
Apart from these examples, people over the age of 65 who experience accidental falls often suffer from traumatic brain injuries, which can have long-lasting impacts on the quality of life. The wrists and legs are also often damaged in these incidents.
How Falling Can Impact Your Physiology
Remember that the consequences of a fall are not always short-term. In many cases, the individual must live with the effects of this accident for years to come, and sometimes, for the rest of their lives. Of course, the most obvious permanent outcome of such an incident is death, which accounts for just shy of 22% of these accidents.
Non-fatal yet long-lasting aftereffects of falling incidents also include “functional decline,” which comprises about 21% of physiological issues. This essentially means that the individual may gradually lose control over the affected body part.
For example, imagine that you tripped over a hazardous object in your home and sprained your ankle. In the months following, you might notice that your ankle is weakening and that you lose motor control over this part of your body. This is a type of functional decline that can be exacerbated by other kinds of decline, including:
- A lack of physical activity (14.9%)
- Becoming physically dependent on someone else (e.g., you may need assistance to move throughout your home, 13.7%)
- Depression (10.3%)
“Other,” Uncategorized Fall Consequences
Not all fall accident outcomes fit into a clean-cut category. Many are miscellaneous in nature, either due to how infrequently they occur or the lack of a substantial scientific research foundation on which to base public and academic awareness. Still, these types of wounds are closely related to the categories listed above, and you may find that there is some overlap in a few of the injury types:
- Lacerations (8.0%)
- Dislocations (5.7%)
- Sprains (3.4%)
- Pains (2.2%)
- Hematoma (1.1%)
Notice that all the physical and physiological impacts described here have the potential to worsen one another. For example, a dislocated shoulder may rob you of your ability to cook dinner or perform your job appropriately. In this case, you may have to depend on someone else to assist you around the house.
Further, the pain may cause you to lose interest in physical activities, leading to functional decline and perhaps even depression. Speaking of depression, you may face several psychological impacts after a fall as an older adult. These are discussed in-depth below.
Psychological Consequences of Falling for Older Adults
A recent study in Newcastle focusing on adults aged 85 years and older found that the quality of people’s lives was deeply impacted by their accident. Each participant had fallen at least once in the year preceding the study, and more than half of them either sustained a fracture, were taken to the emergency department (ED), or were otherwise admitted to a hospital.
The mental and emotional challenges that later developed included the following ( U.S. National Library of Medicine):
- Lower confidence levels (40%)
- Unwillingness or weakened desire to “go out” (25.9%)
- Dizziness and blackouts (40%)
Curiously, women were far more likely to struggle with these problems than their male counterparts. Though there does not seem to be a clear reason for this disparity, healthcare professionals believe that this may be attributed to women’s greater likelihood to consult with a general practitioner regarding their physical condition after the incident, which increases their awareness of the fall’s severity.
How to Prevent Accidental Falls
Your ability to avoid accidental falls is entirely dependent on your physicality and cognitive stability when moving throughout various spaces. While your age and gender – in addition to your work environment, housing, substance use, and medical history – can influence your risk level regarding these incidents, there is still much you can do to prevent the above consequences from befalling you.
The most effective types of preventative measures for falling are described below:
| Occupational TherapyOccupational therapists will first identify the person’s unique risk factors and provide advice on how to improve activity levels and confidence in doing so. To ensure continued success, the OT will then educate victims and caretakers on how to care for their body and the environment to prevent these accidents in the future. (Source: Royal College of Occupational Therapists) | |
| Exercise | You don’t have to lift too much weight or spend hours in the gym to build your muscle and improve balance. Doing any of the following activities at least twice per week can lower your chances of falling due to poor physical health (Source: Public Health England):Sports (e.g., soccer, basketball, racquetball)Light weightliftingResistance trainingRunning or joggingWalking |
| Environmental Management | Clearing your home of any unnecessary hazards, especially tripping hazards and avoidable inclines is a great way to reduce your risk of falling. Slippery flooring and unstable home décor, such as rugs that may shift under your feet, are some of the most notable features that should be addressed in the home or workplace. |
In Conclusion
Older people are more likely to incur injuries and long-lasting detrimental impacts on their health and wellness after a fall. The most common causes of these falls include:
- Impaired balance and vision
- Weak muscles
- A history of falling
- Hazardous living or working conditions
- The simultaneous use of multiple medications
The consequences of these incidents span a wide range, from immediate physical effects like fractures (especially hip fractures), soft tissue injuries, and gradual functional decline, to psychological impacts like lowered confidence and withdrawal from social engagement. Fortunately, accidental falls can be prevented with occupational therapy, exercise, and a safe environment.
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The information contained above is provided for information purposes only. The contents of this Blog article are not intended to amount to advice, and you should not rely on any of the contents of this Blog article. Professional advice should be obtained before taking or refraining from taking any action as a result of the contents of this Blog article. OccupationaltherapyBlog disclaims all liability and responsibility arising from any reliance placed on any of the contents of this Blog article.
