Falls - Older Adults

Falls are the leading cause of injury‐related deaths and hospitalizations for adults aged 65 years and older in BC.

Every 30 minutes, one older adult is hospitalized for fall-related injuries.1 Each day, 1 older adult dies from a fall in BC.2

OVERVIEW

World Health Organization defines a fall as an event which results in a person coming to rest inadvertently on the ground or floor or other lower level, with or without injury.3

The risk of falling and suffering injuries from a fall increases with age, and BC has one of the most rapidly aging populations in Canada.

Between 2012 and 2022, there was a 23% increase in hospitalizations due to fall-related unintentional injuries among older adults in British Columbia. Females were 1.5 times more likely to be hospitalized for such injuries compared to males.1,4

In BC, one in three older adults will fall once every year5 and around half of older adults who fall experience minor injuries, while 5 to 25% will sustain a serious outcome.6 National statistics show that broken or fractured bones are the most common type of fall-related injuries, highlighting the importance of promoting bone health among older adults.7

Falls are the leading cause of loss of independence among older adults5 and may lead to disability, chronic pain, and reduced quality of life. Falls and associated outcomes not only affect the injured individuals, but also have negative impacts for the family, society, health care system and economy.

Falls are identified as the number one source of injury-related costs in B.C. In 2023, the total cost attributed to falls among older adults was $1,337 million. Out of this, direct health care expenses for older adults were $1,125 million, and the remaining $212 million was attributed to indirect costs, representing losses in societal productivity.8

One of the strongest predictors of a future fall is a past fall. Even a fall resulting in minor injuries needs to be taken seriously.

RESEARCH

BCIRPU supports fall prevention efforts at the policy, practice, and community levels. Fall prevention for older adults is one of the provincial priorities for injury prevention.

Fall-related deaths among older adults in British Columbia (2020)

The British Columbia Coroners Service implemented a policy in 2010 advising the reclassification of underlying causes of deaths due to falls from ’natural’ to ’accidental’. This study investigated whether observed data trends reflect this change in practice, are artefacts of inconsistent reporting, or indicate a true increase in fall-related deaths. Results were published in Injury Prevention.

Family physicians’ knowledge, perceptions, and practices regarding frailty in British Columbia (ongoing)

A survey study to better understand perceptions, knowledge, and practices regarding frailty in older adults among family physicians across BC.

Many older adults under-estimate their fall risk and under-report falls.3

PREVENTION

Most falls are predictable and preventable. Fall prevention should focus on promoting independence and activity, and include the older adults and their networks of support (e.g., family, friends, caregivers).

Are you at risk for falls? Take a quick risk assessment test

Reduce fall risk and maintain independence:

  • Exercise to improve mobility, increase muscle strength and balance: Older adults with strong muscles and good balance are less likely to fall. Participation in a safe exercise program designed to improve strength and balance is the single most effective fall prevention intervention.3 If you have an underlying medical condition, discuss your plans for physical activity with your health care provider before beginning an exercise program.
  • Annual eye examinations: Good vision can reduce the risk of falling, while multifocal glasses may pose an added risk for falls, by impairing depth perception or distance contrast sensitivity.3
  • Annual medication review with a doctor or pharmacist: Taking multiple medications is linked to falls. Moreover, some medications can increase the risk of falling, while some increase the odds of a serious outcome if a fall occurs.3
  • Remove tripping hazards in the home and install supports, as needed: Tripping hazards, such as cords, loose rugs, and piles of magazines and books are often overlooked but easy to fix. Physical supports can help avoid falls, such as grab bars in the bathroom.

Finding Balance BC is a provincial effort to educate older adults and their caregivers with the latest fall prevention information. Learn more at findingbalancebc.ca.

RESOURCES

1. Data Source: Discharge Abstract Database (DAD). Retrieved from Health Data Platform, Ministry of Health

2. Data Source: BC Vital Statistics, Ministry of Health. Data accessed from Chronic Disease and Injury Data Mart, BCCDC (as of July 27th, 2023).

3. World Health Organization (2021). Falls. Key Facts. Retrieved from: https://www.who.int/news-room/fact-sheets/detail/falls

4. Government of British Columbia, Guidelines & Protocols Advisory Committee (2021). Fall Prevention: Risk Assessment and Management for Community-Dwelling Older Adults. Retrieved from: https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/fall-prevention

5. Seniors’ Fall Prevention. Government of British Columbia. (n.d.). Retrieved from: https://www2.gov.bc.ca/gov/content/health/managing-your-health/injury-prevention/seniors-fall-prevention

6. Pike, I., Richmond, S., Rothman, L., & Macpherson, A. K. (Eds.). (2015). Canadian Injury Prevention Resource: An Evidence-informed Guide to Injury Prevention in Canada. Parachute.

7. Public Health Agency of Canada. (2014). Seniors’ Falls in Canada, Second Report. Retrieved from: https://www.canada.ca/en/public-health/services/health-promotion/aging-seniors/publications/publications-general-public/seniors-falls-canada-second-report.html

8. Rajabali F, Zheng A, Turcotte K, Bruin S, Pike I. (2022). Cost of Injury in British Columbia 2022. BC Injury Research and Prevention Unit: Vancouver, BC. [Cost from 2018 converted to 2023 dollars using the Bank of Canada inflation calculator.]