Discussion of Healthcare Issue: Falls in Older Adults

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Table of Contents

Background
An Overview of the Problem: Data on Mortality and Risk
Epidemiological and Demographic Data and Characteristics of At-Risk Population
The Goal, Overview, and Objectives of Health People 2020
Population Level Prevention and Health Promotion Review
References

Background

Currently, older adults living in the United States are vulnerable to risk factors related to aging. Thus, falls in older adults are seen as a critical issue frequently resulting in deterioration of individuals’ health and well-being and even leading to fatal consequences. Statistics show that about 3 million older adults are treated in emergency departments for a fall injury each year (Keep on your feet – preventing older adult falls, n.d.). Considering the physical deterioration caused by aging, such individuals require additional support. This paper examines the background of the problem, provides a review of descriptive geodemographic and demographic data, explains the goal and objectives of Healthy People 2020 (HP2020), and introduce interventions made at the population health level.

An Overview of the Problem: Data on Mortality and Risk

With respect to the background of the problem, the following relevant tendencies are known. In the fourth decade of life, the balance system of a human organism experiences a gradual loss of function (Sienko-Awierianow et al., 2018). The respective effects become visible in old age, resulting in postural stability problems, which contribute to falls. Comprehensive assessment of organism dysfunction in the study conducted by Sienko-Awierianow et al. (2018) contributes to the claim that the risk of falls is “an important social problem” (102). Therefore, such an issue is an inevitable consequence of aging.

Concerning mortality and risk statistics, in 2014, 28.7% of community-dwelling adults 65 years or older reported falling (Falls prevention in community-dwelling older adults: Interventions, 2018). Such significant prevalence of the type of cases being discussed results in an increase in mortality rates. As an instance, in 2015, the number of deaths of older adults from falling was estimated to be equal to 33,000 cases. More than 90% of hip fractures are caused by falls, and 25% of adults who sustain it die within 6 months (Falls prevention in community-dwelling older adults: Interventions, 2018, Burden of Disease section.). While no significant correlation between gender and the impact of falls is detected, the risk for such cases increases with age. Thus, a 10 percent increase in the risk between adults aged 65 to 74 years and adults aged 85 years or older is stated in the article Falls prevention in community-dwelling older adults: Interventions (2018., section Burden of Disease). It is possible to notice the substantial vulnerability of older adults to falls.

Epidemiological and Demographic Data and Characteristics of At-Risk Population

The description of the term “falls in older adults” can be provided with respect to descriptive epidemiology. From the “person” perspective, the population affected is elderly (65 years and above, with an average of 85.4) people, which were injured after a fall (Older adults, n.d., Falls prevention in community-dwelling older adults: Interventions, 2018, Burden of Disease section.). They either have a medical condition or are physically inactive in everyday life. Gender, occupation, and socioeconomic status are irrelevant. Regarding “place,” the issue is prevalent over the world, without specific relation of a particular territory and rural-urban status. From the perspective of “time,” there is no specific period when a vulnerability to falls occurs within the specified above age ranges. However, it is well-known that risks are gradually increasing over time, revealing the maximal probability of fatal fall close to the upper age limit. It is possible to observe from the description that falls in older adults are a global issue globally prevalent among physically inactive persons and ones with medical conditions.

Concerning brief risk assessment for the population using HD2020 specified criteria and provided recourses, the factors are the following. Age is strongly related to risk for falls, while impairments in mobility, gait, and balance contribute to physical malfunctioning (Falls prevention in community-dwelling older adults: Interventions, 2018). The other respective statistics can be shown to examine demographics critically. People age 65 and above represent 16% of the population in 2019, and the proportion is expected to grow further. Two years ago, the number of aged individuals equated to 24.1 million men and 30 million women (The Administration for Community Living, 2021, p. 3). It is expected that the number of persons age 65 and older in the US will reach 94.7 million in 2060. Thus, the issue can be stated as one of high importance.

The Goal, Overview, and Objectives of Health People 2020

HP2020 is the program intending to research key health-related problems and viable interventions to address them and facilitate progress toward goals. The website has an online database incorporating numerous evidence-based studies. HP2020 provides four overarching goals closely related to the discussed issue. The first is to attain high-quality, longer lives free of disease, injury, and premature death. The second is to achieve health equity, eliminate disparities, and improve the health of all groups. The third is to create social and physical environments to promote good health for all. The last is to promote quality of life, healthy development, and healthy behaviors across all life stages (Older adults, n.d.). It is possible to emphasize that the core outcome expected from a reduction in the risk for older adults to fall is ensuring longer lives of better quality. It is a direct reflection of all the four objectives described above.

HP2020 provides a guideline for screening the population with greater chances of being injured from falling. It includes recommendations for examination patient’s medical history for prior falls and gait or balance problems. Such a multifactorial screening strategy may also incorporate age consideration and paying attention to an individual’s physical state (Older adults, n.d.). The validity power of the screening tool method is high due to the abstractedness of the diagnosis and the presence of constructive factors enabling to predict the case of fall with a certain probability (Carstensen et al., 2019). The tool is applicable for the entire population but does not provide evidence-based results because the chances of falling may fluctuate in their values.

Population Level Prevention and Health Promotion Review

Concerning interventions implemented, there are several that proved themselves to be viable. According to HP2020, exercise interventions are highly recommended for reducing the risk for falls in community-dwelling adults 65 years or older without osteoporosis and lack of vitamin D (Older adults, n.d.). The other proposed solutions are combinations of psychological interventions, environment modifications, medication management, nutrition therapy, and urinary incontinence management (Older adults, n.d.). It is possible to reveal the outcomes of such interventions’ implementation. The multidisciplinary approach decreased the potential chances for groups of participants to experience fall cases, which was equated by mean of data abstraction to overall health level, by a third (Slade et al., 2017; Pillay et al., 2021). Statistical majority of participants reported improvement in attitude towards falls. In the US, such an evidence-based, multidisciplinary approach is claimed to be gradually implemented by a growing number of clinics (Older adults, n.d., Pillay et al., 2021). Therefore, there is an improvement in the area of reduction of falls in older adults.

References

Carstensen, G., Rosberg, B., Kevin, J., & Åberg A. (2019). Before evening falls: Perspectives of a good old age and healthy ageing among oldest-old Swedish men, Archives of Gerontology and Geriatrics, 82, 35-44, Web.

Falls prevention in community-dwelling older adults: Interventions. (2018). Web.

Keep on your feet – preventing older adult falls. (n.d.). Web.

Older adults. (n.d.). Web.

Pillay, J., Riva, J.J., Tessier, L.A. et al. (2021). Fall prevention interventions for older community-dwelling adults: systematic reviews on benefits, harms, and patient values and preferences. Syst Rev, 18. Web.

Sienko-Awierianow, E., Lubkowska, A., Kolano, P., & Chudecka, M. (2018). Postural stability and risk of falls per decade of adult life – a pilot study. Pathogens, 8(1), 102-109. Web.

Slade, S., Carey, D., Hill, A., & Morris M. (2017). Effects of falls prevention interventions on falls outcomes for hospitalised adults: protocol for a systematic review with meta-analysis, Archives of Gerontology and Geriatrics, 7(11), e017864, Web.

The Administration for Community Living. (2021). 2020 Profile of older Americans. Web.

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