South Dakota Fall Prevention Coalition Mobilizes to Address Falls Among Older Adults

Across the nation, a fall is the leading cause of injury among adults age 65 and older. Adults age 85+ were more likely to report a fall or fall-related injury in proceeding year than those younger than 85.  In 2018, 27.5% or one in four older adults reported at least one fall in the past year (35.6 million falls) and 10.2% reported a fall-related injury. A head or a hip injury are the most common fall-related injury.

In 2016, nearly 1 in 10 adults age 45 or older in SD reported a fall with an injury. Between 2011 and 2018, there were

·         15k fall-related hospitalizations

·         117K fall-related injuries

In 2017 and 2018, a fall was the leading cause of trauma-related injury and death. Half of the fall-related deaths were among adults age 85 or older. Finally, SD 5th in Nation for Deaths from fall between 2007 and 2016.

What is not always well understood among professionals without gerontology training, is health and aging. It is critical that both chronic disease and frailty not be viewed as inevitable outcomes of the aging process. Chronic diseases and falls are outcomes that can be linked to specific causes. In addition, these outcomes can be impacted through evidence-based interventions.

It is important to describe what the research says about the relationship between chronic disease and fall risk. Chronic diseases affect the body in ways that lead to reduced sensitivity in extremities, walking abnormalities, balance/gait issues, muscle weakness, changes in lung capacity, or medication use. People who are recurrent fallers have a higher number of diseases compared to non-fallers. Self-reported fall percentages increased significantly as health status decreased. Having a medical history of stroke, chronic kidney disease, arthritis, depression, and diabetes independently predict the risk of first-time falling, as well as the risk of recurrent falling. Having a medical history of heart attack, angina, asthma, and COPD do not predict the risk of first-time falling, but did predict the risk of recurrent falling after experiencing the first fall in this population.

  • The highest fall injury percentages were among those who reported depression and stroke.

  • Those with depression reported the highest adjusted fall injury percentage.

  • Research suggests a higher likelihood of falling in an indoor setting in the presence of 17 chronic conditions found in the Charlson Comorbidity Index, as an example mild liver disease or dementia

Direct medical costs include fees for hospital and nursing home care, doctors and other professional services, rehabilitation, community-based services, use of medical equipment, prescription drugs, and insurance processing.

Direct costs do not account for the long-term effects of these injuries, such as disability, dependence on others, lost time from work and household duties, and reduced quality of life.

Nationally, falls cost the United State Medical system $50 billion, with those costs paid by Medicaid, Private or out-of-pocket payers, or Medicare. Medicare is largest payer at $29 billion. Fatal falls cost an additional $754 million.

Prior to 2020, the South Dakota Fall Prevention Coalition was inactive. Sanford Health and SDSU Extension partnered together to revitalize the coalition at the end of 2019. We now have over 30 organizations represented on the coalition. The vision of the South Dakota Fall Prevention Coalition is that Older South Dakotans will have fewer falls and fall-related injuries, maximizing their independence and quality of life. The mission of the South Dakota Fall Prevention Coalition is to cultivate collaboration to reduce falls by increasing knowledge and implementing evidence-based fall prevention solutions for older adults.

The Coalition goals are to Reduce the number of fall related deaths by 5% and reduce the number of fall related hospitalizations by 10% by 2025 or 2026. The coalition is currently Working to develop a sustainability plan for the coalition; we promoted Fall Prevention Awareness Week in September (20th to 24th); and we are Recruiting additional members. To learn more about the coalition, please visit the State Trauma System website: https://doh.sd.gov/providers/ruralhealth/trauma/FallsPrevention.aspx.

Chrissy Meyer