Rate of falls in elderly increases

This is odd. Falls are a big risk for people my age--that's not news. But I wonder why the rate is so much higher now than when my grandparents were in their 80s (died in 1983). This author's opinion is the soaring use of prescription drugs. Fall risk drugs are called FRIDs. Mortality from falls has increased much more in the US than other high income countries. https://jamanetwork.com/journals/jama-health-forum/fullarticle/2837039? 

"The surge in deaths from falls in the US reflects a new phenomenon. There is no reason to think that older adults today are much more likely to be physically frail, have dementia, have cluttered homes, or drink alcohol and use drugs than age-matched adults 30 years ago, and the percentage living alone has not changed much since 2000. On the other hand, there is plenty of reason to believe that the surge in fall deaths may be tied to the soaring use of certain prescription drugs,3 which is a risk factor that, unlike most other factors, clinicians can readily modify."

Ten exercises to improve balance for Seniors

 Putting this here so I can find it. There are not a lot of good spaces in our home to do these, however, some don't take a lot of room. https://youtu.be/cAOK3apyCOc?si=9L4TLOSMLFj8qluA  I often read the comments: 

"Thank you so much i am 84 yrs old .at last exercises i can actually do." 

Sounds like me!

"I am in PT right now to work on my walking. Most of these exercises have been given to me to do. My balance was terrible when I started. Now it's much better. The exercises help if you put in the effort. Keep trying if you start, you will improve."

Doug Weiss, this instructor, has a webpage with a good overview lecture, and highlights of many videos. How to WALK to prevent Falls (youtube.com)  He has some good advice on using a walker in order to increase your miles and balance--uses the example of using a shopping cart at the store. Home | Proprioceptive Rehab

Proprioception: What It Is, Disorder, Symptoms, and More (webmd.com)

Bone health and falls

 I don't think a lot about fractures or bone health--until--a friend falls after stepping on a stone or sidewalk irregularity, or my friend Cindy fractures her thigh after taking the same med I do for osteoporosis, or Karen a woman I met at the gym fractures her foot playing pickleball, or Jim's wife falls over the leaf blower in their garage, or I fall in the shower.

That last fall happened a week ago, Christmas Eve morning.  I fell in the shower.  It wasn't the usual slip on the soap or not having a grab bar.  I had the brilliant idea that in order to protect the paint on the bathroom walls when I use hair spray, I'd spray my hair inside the shower stall where it could be washed off.  So, I was completely dressed, except for shoes--I was wearing light slippers.  My hair (which is thinning) was just the way I wanted it. I picked up the container and stepped inside the shower, which was still damp. It was a little awkward, but I could see the mirror and sprayed my hair.  Then as I stepped out--holding on to the door and the other hand on the opening with 2 fingers while holding the spray--the slipper stuck briefly on the floor of the shower.  That was enough for me to lose my balance and I went down. As I knelt there with my right knee on the slightly raised marble frame and the other pressed against the glass, I had to struggle to get up. My legs are weak but my arms are fairly strong--even so it was a long haul to get upright. A few bruises, but no sprains or fractures.  Whew!

Four other bad falls come to mind.  In the 1990s (I was in my 50s) I was walking briskly down the hall in the old Sisson building of the Veterinary College at Ohio State where I was the librarian. I didn't know that one of the labs on the second floor had a leaking faucet, and water had run under the door and into the hall.  The halls were not well lit, and as I hit that water (in those days I wore high heels to work), my legs flew out and I went splat landing on my back with one leg forward and one back.  It knocked the breath out of me, momentarily paralyzing me. The halls were empty--nothing to use to pull myself up and no one to help--so I just waited to catch my breath and then gradually using the walls for support and grabbing the doorknob to the lab stood up. Nothing broken, but I was so sore I could hardly move.  I recall looking into filing for Worker's Comp, but it was way too complicated, and I never followed through.

Then after I retired and we were spending the summers at our lake house on Lake Erie, I fell down the last four stairs in the basement carrying a laundry basket--probably in 2007.  I seem to remember the date because I wore the bruises to a class reunion. I was alone in the house (the last time I ever went to the basement without someone in the house). Again, nothing broken.  I crawled up the stairs, and into one of the bedrooms to lie down.  I eased off my shoes and my jeans.  I had bruises from knees to toes, and the shoestrings of my athletic shoes had left bruise marks on my feet in a crisscross pattern.

Also at Lakeside was my last bicycle ride when I was 70.  I was leaving a morning meeting at the hotel on Third Street, Fountain Inn, got on my bicycle (a no-speed from 1968), wobbled a bit, and fell--into a stop sign at Third and Maple, about 15 ft from where I got on it! The stop sign made a loud noise as I hit it--Boing, Boing. And people came running from their cottages to help the old lady on the ground. I lived just two blocks so someone (don't remember who) walked me home, wheeling the bike which I never rode again.

But the worst fall of my life wasn't actually my fall, but when my horse fell on me! It was probably 1952 so I was 12 years old, and had owned the horse only a few days. The bit was too tight (I figured out later) and the horse kept backing up, then started to rear, I began to slip off the back, but the horse lost his footing and fell--on top of me.  That REALLY hurt. The horse strolled away, and my mom came running out of the house. Nothing was broken, and I lay around for a few days, and today each time I get a back spasm I blame my horse.

Falls in the elderly statistics by CDC are all over the place and don't make a lot of sense.  Illinois elderly seem to be less likely to fall than Ohioans.  Whites more than minorities, women more than men, but the death rate for men is higher than for women. Of course, the statistics don't reflect the falls that are never reported--like mine--because I didn't get medical help.  Even so, 14,000,000 for people over 65 is nothing to be sneezed at.  The age adjusted fall death rated increased by 41% from 55.3 per 100,000 older adults in 2012 to 78.0 per 100,000 older adults in 2021. I personally attribute that to the fitness craze--people are taking more chances and think they are 40 instead of 80.

Ladders are really dangerous. According to the CDC each year in the U.S., more than 500,000 people are treated and about 300 people die from ladder-related injuries. The estimated annual cost of ladder injuries in the U.S. is $24 billion, including work loss, medical, legal, liability, and pain and suffering expenses.

It’s National Ladder Safety Month | Blogs | CDC

Nonfatal and Fatal Falls Among Adults Aged ≥65 Years — United States, 2020–2021 | MMWR (cdc.gov)

Hip Fracture Overview - StatPearls - NCBI Bookshelf (nih.gov)

Falls and Fall Prevention in Older Adults - StatPearls - NCBI Bookshelf (nih.gov)

The risk of falls among the aging population: A systematic review and meta-analysis - PMC (nih.gov)

Lifestyle Approaches to Promote Bone Health - Bone Health and Osteoporosis - NCBI Bookshelf (nih.gov)

Nutritional Supplements and Skeletal Health - PubMed (nih.gov)

Vitamin K as a Powerful Micronutrient in Aging and Age-Related Diseases: Pros and Cons from Clinical Studies - PMC (nih.gov)

Biden's shaggy dog tail

 Now Joe Biden says he slipped and broke his foot because he got out of the shower and chased his dog and slipped on a rug.

Adults older than 65 years of age suffer the greatest number of fatal falls. 37.3 million falls that are severe enough to require medical attention occur each year. Will we have 37.3 million people hospitalized with Covid this year? Should we destroy our economy because old people fall and need medical attention? The one-year mortality rate in seniors over 60 is as high as 58% following injuries related to trips, slips, and falls, statistics in the elderly show. For Covid it's 5.6%. Should the schools close? The death rate for older Americans is much higher for whites than blacks--it's much higher in Wisconsin than in Alabama, but to my knowledge no one has a grant to determine the cause of the racial gap.

That said, how do you get the picture of a wet, naked Biden chasing a dog out of your head?

Flu, pneumonia and falls

From October 2018 through early May 2019, up to 61,200 people died due to flu complications, while up to 647,000 people were hospitalized, according to preliminary estimates from the Centers for Disease Control and Prevention (CDC). During the 2017-2018 flu season, approximately 900,000 people were hospitalized and 80,000 people died due to flu complications. (Prevention website)

Every 19 minutes, an older adult dies from a fall. Falls are the leading cause of fatal injury and the most common cause of nonfatal trauma-related hospital admissions among older adults. 50,000/year.  Those who are hospitalized often die of pneumonia.

So let's guestimate that about 150,000 older adults die each fall/winter season from just these 3 problems, and maybe a million are hospitalized plus thousands of younger people who are also susceptible at a lower rate because they may have preexisting conditions like heart, lung, kidney problems, or do silly things like climb ladders to clean gutters. Only the family and friends care when they die--they mourn their losses and pay the bills. We cry and share stories about grandma or the neighbor who used to help us out with maintenance or walking the dog. We spend hours settling estates and packing up or distributing the earthly wealth of those we loved. We give away watches from the retirement gala, the jewelry box, and old Bibles. We personally have the gold pocket watches of both Bob's father and grandfather, we have my grandmother's hymn book from her college days in the 1890s, and my grandfather's 11th, 12th and 13th editions of Encyclopedia Britannica. We know how they died and it wasn't a pandemic, but was from common problems of aging. But we didn't close up shop, we didn't deny medical care to others for different, less fatal causes, we didn't stop having Easter services, and we didn't destroy our pensions and equity in our homes because maybe 200,000 people died of illnesses that had been with us since the people made a golden calf to worship just in case Moses got it wrong.

https://www.prevention.com/health/health-conditions/a22813625/flu-symptoms-prevention/

https://www.cdc.gov/nchs/fastats/pneumonia.htm

Michael Smith adds some perspective to death statistics

"I'm not trying to minimize the deaths from the Coronavirus pandemic but when I heard a report yesterday that now in New York, one person dies every 17 minutes due to the disease and that it could get to one person every 9 minutes.

So I checked to see if I could find comparable numbers anywhere on the CDC's website and here's what I found:

Mortality reason #1:
Number of deaths: 36,338
Deaths per 100,000 population: 11.2
Death rate - 1 person per every 15 minutes - comparable to the current mortality frequency of the pandemic in New York.

Mortality reason #2:
Number of deaths: 64,795
Deaths per 100,000 population: 19.9
Death rate: 1 person every 8 minutes - comparable to the predicted mortality frequency of the pandemic in New York.

Mortality reason #1 - unintentional falls.
Mortality reason #2 - unintentional poisonings.

One might think the moral panic is being stoked by the way this pandemic is being promoted in the media.

I don't know how to get people to look at this pandemic with any sense of proportionality - there's just too much fear out there that blocks any sense of rationality."

Splat! I fell at the library

The death rate from falls among the elderly is increasing, and no one seems to know why. In 2007, the rate of death due to falls was 47 per 100,000. This rate increased to 61.6 per 100,000 in the year 2016. Is it better records, or the baby boomers still taking risks?

I fell today. It wasn't far, and I wasn't hurt, but I sure felt foolish and I don't think anyone saw me. I was at the library which always has a nice display of used books for sale. They are arranged low on 3 shelf book trucks. So I sort of squatted down to get a better look and I tipped over! I kid you not. Splat. I was on the floor. So I sort of rearranged my legs to look like kids do sitting on the floor to browse the books. Of course, then I had to get up from that position! It was a struggle, but I did it. For just $2.00 I got 2 nice books I didn't need.

Update from my 84 year old Lakeside neighbor, Dorothy?

Oh boy, DO I IDENTIFY!!!

Back a few weeks, I fell out of bed trying to get to bathroom, hit my head on nightstand (black eye resulted), happened at 3:30 a.m. SO NO ONE AROUND to SEE. Bleeding profusely from leg wound that scraped metal part on walker which was close to bed (required 9 stitches).  YES, I drove myself to ER, no one ahead of me, got right in - I wasn't about to call 911 & have WHOLE neighborhood awake & asking questions the next day, NO WAY. WAS FUN going thru ALL RED LIGHTS, at 3:30 a.m. NOT MANY OTHERS OUT & NO Police cars IN SIGHT .

Injuries from falls vary by race, ethnicity and gender

I've had 2 bad falls in the last 2 years--one on the basement stairs, and one on my bike. No broken bones, but huge bruises one which will be permanent. So I'm paying attention and have learned some odd things: whites are more likely than blacks or Hispanics to have fall injuries and death; the death rate for men is 40% higher than women; the death rate from falls has gone up sharply in the last decade; 75 is a lot more dangerous than 65; there are over 258,000 hip fractures and the rate for women is almost twice the rate for men; hip fractures are much more common in white women than black.

http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html

• Twenty to thirty percent of people who fall suffer moderate to severe injuries such as lacerations, hip fractures, and head traumas. These injuries can make it hard to get around or live independently, and increase the risk of early death.
• Falls are the most common cause of traumatic brain injuries (TBI).
• About one-half of fatal falls among older adults are due to TBI.
• Most fractures among older adults are caused by falls. The most common are fractures of the spine, hip, forearm, leg, ankle, pelvis, upper arm, and hand.
• Many people who fall, even if they are not injured, develop a fear of falling.  This fear may cause them to limit their activities, which leads to reduced mobility and loss of physical fitness, and in turn increases their actual risk of falling.

In 2013, the direct medical costs of older adult falls, adjusted for inflation, were $34 billion.