Unintentional Fall-Related Injuries and Deaths Among Seniors in British Columbia: Trends, Patterns and Future Projections, 1987-2012
Fall-related injuries and deaths in older adults are a major public health problem in most contemporary western societies with aging populations (Carter, Kannus & Khan, 2001; Tinetti & Speechley, 1989). Approximately 30% of individuals over 65 years of age fall at least once a year (Campbell, Borrie, & Spears, 1989), and about half of these do so recurrently (Tinetti & Speechley, 1989). Given these statistics, and the changing age structure of the Canadian population, many concerns have been raised surrounding the prospective burden of such injuries on society, including demands on the health care system and the quality of life among the aged and their caregivers.
In Canada, falls are responsible for about two-thirds of all injury-related discharges from hospital, and more than 70% of injury-related days of hospital care (Raina et al., 1997). Falls among the elderly can result in serious fractures and long periods of recovery (Wilkins, 1989; Raina et al., 1997). In particular, over 90% of hip fractures result from falls (Grisso et al., 1991), and in individuals who sustain hip fractures, the outcome is fatal in 12% to 20% of cases (Riggs & Melton, 1986).
In British Columbia, from 1987 to 1998, falls and motor vehicle traffic injuries were the leading causes of death by injury among adults 65 years and over (Soubhi, Lisonkova, Rajabali, Tufts, & Raina, 2001). During this 12-year period, rates of falls as a cause of death were steadily maintained at high levels among the 75 years old and over group. Falls were also the first leading cause of hospitalization due to injury among the 35 years old and over group. Analysis of the trends over the 12-year period revealed that among the 65 years old and over group, the rate of falls remained stable across the years. These facts highlight the implications for BC in terms of health care expenditures and personal costs. In fact, falls in the elderly were estimated to cost BC $180 million in direct costs in 1998 alone (Cloutier & Albert, 2001).