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Sunday, September 20, 2009

New Mexico's Fall-Related Death Rate Is Nation's Highest

By Dr. Carla Herman And Frieda Gonzales
UNM Center on Aging N.M. Department of Health
          Tuesday, the first day of fall, is "National Fall Awareness Day," a day that spotlights fall prevention for older adults.
        Every year, nearly 1,500 New Mexicans 65 years and older are hospitalized for fall-related injuries, and about 230 die from those injuries. Remarkably, New Mexico's fall death rate is greater than two times the national rate for people 65 years or older — in fact, we have the highest fall-related death rate in the nation for all ages. These statistics represent one preventable tragedy after another.
        Hip fractures and traumatic brain injuries are the most serious fall-related injuries in older adults and can severely limit mobility, or make independent living altogether impossible. These injuries also can increase the risk of early death. Of those older adults hospitalized from a hip fracture, 40 percent never return home or live independently again, and 25 percent die within one year. Additionally, older adults can develop a "fear" of falling, which can lead to isolation, depression, and reduced mobility.
        Personal fall risks can include impaired gaits, balance problems, muscle weakness, reduced vision or depth perception, mental confusion and so on. Participation in balance and coordination exercise programs can help seniors stay strong and flexible.
        Medications also can affect balance and coordination. Reviewing side effects and drug interactions with a health care provider prior to each new prescription can avoid problems.
        Fall risk factors at home include poor lighting, uneven flooring, loose rugs, staircases and cluttered areas. And, finally, environmental risks, like uneven or deteriorating sidewalks, rough, unpaved or slippery pavements, and abrupt changes in a walkway's grade can lead to falls. Checking for hazards inside and around the home and making modifications to home and community settings also can prevent falls.
        Falls are a costly drain on our health care system. The estimated annual medical costs for fatal fall injuries to New Mexicans age 65 and older is more than $3.3 billion. Research shows that preventing fall injuries requires an approach that addresses both individual and environment risk factors. The work of the New Mexico Adult Falls Prevention Coalition follows a national action plan based on this research — Falls Free: Promoting a National Falls Prevention Action Plan, developed by the National Council on the Aging. The coalition is a statewide, multi-disciplinary group of organizations and individuals led by the New Mexico Department of Health's Office of Injury Prevention. The plan identifies four goal areas: physical mobility, medication management, home safety and environmental safety in the community.
        We can prevent the devastating consequences of falls for the thousands of New Mexicans at risk. Seniors, caregivers, health care providers, and public officials can work to get these prevention strategies adopted into practice. Fall Awareness Day is a day to respond and commit to these life-saving and cost-effective strategies.
        For more information, contact Frieda Gonzales at the New Mexico Department of Health, 505/827-2589, or frieda.gonzales@state.nm.us. The National Action Plan is available at: http://www.healthyagingprograms.org/resources/FallsFree_NationalActionPlan_Final.pdf
        Dr. Carla Herman is chief of the Division of Geriatrics – Department of Internal Medicine, UNM Center on Aging. Frieda Gonzales, a registered nurse, is a health eductor with the state Department of Health. Susan DeFrancesco of the UNM Department of Pediatrics, Division of Prevention and Population Sciences also contributed to this article.