Falls take a rising toll on older brains

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Mike Stobbe

Older adults are suffering concussions and other brain injuries from falls at what appear to be unprecedented rates, according to a new report from U.S. government researchers.

The reason for the increase isn’t clear, the report’s authors said. But one likely factor is that a growing number of older people are living at home and taking repeated tumbles, said one expert.

“Many older adults are afraid their independence will be taken away if they admit to falling, and so they minimize it,” said Dr. Lauren Southerland, an Ohio State University emergency physician who specializes in geriatric care.

But what may seem like a mild initial fall may cause concussions or other problems that increase the chances of future falls — and more severe injuries, she said.

Whatever the cause, the numbers are striking, according to the new report by the Centers for Disease Control and Prevention.

One in every 45 Americans 75 and older suffered brain injuries that resulted in emergency department visits, hospitalizations or deaths in 2013. The rate for that age group jumped 76 percent from 2007. The rate of these injuries for people of all ages rose 39 percent over that time, hitting a record level, the CDC found.

The report, which explored brain injuries in general, also found an increase in brain injuries from suicides and suicide attempts, mainly gunshot wounds to the head. Brain injuries from car crashes fell.

Fall risk factors

But older adults suffered at far higher rates than any other group.

It’s well known that falls among older adults are common. They are more likely to have impaired vision, dizziness and other de-stabilizing health problems, and are less likely than younger people to have the strength and agility to find their feet once they begin to lose their balance.

The CDC had already reported that falls were the top cause of injuries and deaths from injury among older people; an estimated 27,000 Americans die each year from falls.

But even experts on elderly falls said the new numbers were striking.

Health officials have been increasing their focus on brain injuries among all ages, especially younger people. CDC investigators thought the overall rise in brain injuries might be mainly caused by rising awareness of sports-related head injuries in kids and young adults, and more diagnosis of injuries in that group that in the past were not recorded.

“But when we dug a little bit more into the numbers, we found the larger driver is older adult falls,” said the CDC’s Matt Breiding, a co-author of the new report.

The toll from such falls has been under-recognized by physicians and by seniors themselves, Southerland said. When falls do occur, older people tend to downplay it, she said.

One fall begets another

But one fall can quickly lead to others. In a study published last year, Southerland and other Ohio State researchers found that more than a third of older adults with minor head injuries end up back in the ER within 90 days.

Even when they see a doctor, the future risk may be missed. In hospital emergency departments, it’s not unusual for a 25-year-old athlete who fell on his head to get a more thorough evaluation for concussion than an older retiree, said Southerland, who is trying to develop a standard for assessing concussions in geriatric ER patients.

Surveys show that most older adults want to live at home for as long as possible.

Research is mixed on what the healthiest and safest setting is for a senior — often it depends on the individual. “There are people falling in nursing homes as well,” Southerland said.

Older adults are advised to have their vision checked regularly, and to do Tai Chi or other exercises that can strengthen legs and improve balance.

Experts also advise making an older person’s home safer by removing loose rugs and other tripping hazards, improving lighting, and installing handrails and grab bars on stairs and in bathrooms.                 

                                                                                                                         — AP