Report: Women fall more, but men face higher death rate from falls

Key takeaways:

• In 2020, the percentage of women who reported falling was 28.9%; for men, it was 26.1%.
• The next year, 34 states saw significantly higher age-adjusted death rates for men.

Despite women reporting more falls overall, men died from falls at higher rates, according to results published in MMWR.

In the United States, unintentional falls is the leading cause of injury and injury-related deaths among older adults, Ramakrishna Kakara, MPH, a CDC researcher, and colleagues wrote. Across the country in this age group, it is estimated that the medical costs from falls amount to about $50 billion each year.

“Although the estimated prevalence of nonfatal and fatal falls increases with age, falls are not an inevitable part of aging,” they wrote. “Older adult falls can be prevented by addressing modifiable risk factors through effective preventive strategies.”

Because of geographic and demographic variation in fatal falls in the U.S., Kakara and colleagues sought to identify differences in estimates of both fatal and nonfatal falls by state and sex.

They used data from the 2021 National Vital Statistics System and the 2020 Behavioral Risk Factor Surveillance System to estimate the percentage of older adults who reported falls during the previous year and the rates of unintentional fall-related deaths. They stratified measures by states, demographic characteristics and U.S. Census Bureau region.

For the year 2020, Kakara and colleagues found that 14 million older adults — 27.6% — reported that they had fallen during the previous year. The percentage of older adults reporting falls varied from 19.9% in Illinois to 38% in Alaska.

In 2021, unintentional falls killed 38,742 older adults (78 per 100,000 population), ranging from 30.7 per 100,000 in Alabama to 176.5 per 100,000 in Wisconsin.

Notably, although the percentage of men who reported falling (26.1%) was lower than that for women (28.9%) in 2020, the death rate of unintentional falls was higher for men (91.4 per 100,000) than for women (68.3 per 100,000) in 2021. In 34 states, age-adjusted death rates were significantly higher for men than women.

The U.S. Preventive Services Task Force currently recommends that older adults exercise to prevent falls. For those at an increased risk for falls, the USPSTF recommends physicians “selectively offer multifactorial interventions to prevent falls.”

Karaka and colleagues wrote that CDC’s Stopping Elderly Accidents, Deaths and Injuries initiative recommends that physicians “screen older adults for risk of falling, assess those at risk to identify modifiable risk factors, and intervene with effective strategies (eg, physical therapy, home modification, and medication management) to address each risk factor.”

“Everyone, including state, tribal, and local health departments and organizations working with older adults can help older adults self-screen for their risk of falling, using the online falls free checkup, and encourage older adults to speak to their health care provider,” they concluded.

References:

• Kakara R, et al. MMWR Morb Mortal Wkly Rep. 2023;doi:10.15585/mmwr.mm7235a1.
• USPSTF. JAMA. 2023;doi:10.1001/jama.2018.3097.