March 17, 2023 — When Senate Minority Leader Mitch McConnell (R-KY) recently collapsed at a dinner event in Washington, DC, he unfortunately joined a large group of his fellow senior citizens.
This is not the first fall the 81-year-old has taken. In 2019, he fell in his house, breaking his shoulder. This time, he suffered a concussion and was recently released from an in-patient rehabilitation facility. Although McConnell didn’t fracture his skull, in falling and hitting his head, McConnell became part of an emerging statistic: one that shows falls are more dangerous for senior men than senior women .
This new research, which appeared in American Journal of Emergency Medicinecame as a surprise to lead researcher Scott Alter, MD, associate professor of emergency medicine at Florida Atlantic University College of Medicine.
“We always hear about lower bone density rates in women, so we didn’t expect to see men with more skull fractures,” he said.
Alter said that as a clinician at a facility in south Florida, her ER department was the perfect study area to evaluate incoming geriatric patients due to falls. Elderly “patients are at higher risk of skull fractures and intercranial bleeding, and we want to look at any patient who presents with a head injury. About 80% are fall-related, however.
Statistics show the fact that falls of all kinds are incredibly common among the elderly: approximately 800,000 adults end up in the hospital each year due to falls.
The numbers show that death rates from falls have also increased in the senior citizen age group, which also increased by 30% from 2007 to 2016. Falls account for 70% of accidental deaths in people 75 and older. They are also the leading cause of injury-related visits to emergency departments in the country.
Jennifer Stevens, MD, a gerontologist and executive director at Florida-based Abbey Delray South, is aware of dire numbers and sees their consequences regularly. “The reasons why seniors are at high risk for falling are many,” he said. “These include balance issues, decreased strength, diseases like Parkinson’s and Alzheimer’s, side effects of their medications, and more.”
In addition, many seniors live in spaces that are not necessarily equipped for their limitations, and risks exist throughout their homes. Put it together, and the dangers for falling are everywhere. But there are steps seniors, their families, and even middle-aged people can take to reduce and hopefully prevent dangerous falls.
Stare early
Although in many cases the journey to reduce fall risks begins after the fall, the time to begin addressing the issue is long before you reach your senior years. Mary Therese Cole, a physical therapist and certified dementia practitioner at Manual Edge Physical Therapy in Colorado Springs, CO, says age 50 is a good time to start paying attention and addressing physical declines.
“This is an age where your vision can start to deteriorate,” he says. “This is a big reason why older adults trip and fall.”
Additionally, as our brains begin to age in our middle years, the neural pathways from the brain to the extremities also begin to decline. The result is that many people stop lifting their feet as much as they used to, making them more likely to trip.
“You’re not old, but you’re not a spring chicken either,” Cole said. “Any issues you have now will only get worse if you don’t.”
A good starting point in middle age, then, is to work on both strength training and balance exercises. A certified personal trainer or physical therapist can help get you on a program to ward off many of these rejections.
If you’ve reached your later years, however, and are experiencing physical declines, it’s wise to check in with your primary care doctor for an assessment. “He can start your regular PT to check for any deficiencies and then address them,” says Cole.
Cole says when she works with a senior patient, she will assess their strength getting into and out of a chair, do a manual strength test to check the lower extremities, check their walking stride, and ask about conditions like diabetes, previous surgeries, and other conditions.
From there, Cole said he can write a plan for the patient. Also, Stevens uses a program called Be Active that allows him to test seniors on a variety of measures, including flexibility, balance, hand strength, and more.
“Then we match them with classes to address their deficiencies,” he said. “It’s very important that seniors have the ability to recover and not fall if they lose their balance.”
Beyond working with your physical limitations, looking after your home is also important. “You can have an occupational therapist come to your home and do an evaluation,” says Stevens. “They can help you reorganize and reorganize for a safer environment.”
Major and common household fall hazards include throw rugs, lack of night lights for middle-of-the-night bathroom visits, lack of shower/bathtub grab bars, and furniture that blocks walkways.
For his part, Alter likes to point seniors and their doctors to the CDC STEADI program, which aims to stop accidents, deaths, and injuries to the elderly.
“This includes screening for fall risk, assessing factors you can change or improve, and more tools,” he says.
Alter also recommends seniors talk to their doctor about medications, particularly blood thinners.
“At a certain point, you have to weigh the benefits of preventing pain with the risk of injury if you fall,” he says. “The risk of bleeding may be too high if the patient is at high risk of falling.”