Falls in Older Adults: Burden and Population

Why falls matter

According to USPSTF Recommendation Statement: Interventions to Prevent Falls in Community-Dwelling Older Adults (JAMA, 2018), falls are the leading cause of injury-related morbidity and mortality among older adults in the United States. The burden is large: in 2014, 28.7% of community-dwelling adults age 65 years or older reported falling. This amounted to about 29 million falls. Of those falls, 37.5% required medical treatment or caused restricted activity for at least 1 day. The report also cites an estimated 33,000 deaths in 2015 related to falls.

Who the recommendation covers

The recommendation in USPSTF Recommendation Statement: Interventions to Prevent Falls in Community-Dwelling Older Adults (JAMA, 2018) applies to:

• Community-dwelling older adults
• Age 65 years or older
• Adults who are seen in a primary care context for prevention of falls

The source specifically describes this population as community-dwelling adults age 65 years or older. It is not focused on younger adults, and it addresses falls prevention in older adults living in the community rather than other settings.

How increased fall risk is identified

USPSTF Recommendation Statement: Interventions to Prevent Falls in Community-Dwelling Older Adults (JAMA, 2018) explains that clinicians identify older adults at increased risk for falls using several practical indicators.

1. History of falls

A history of falls was described as the factor most commonly used and one that consistently identified people at high risk for future falls. This means that asking whether a person has fallen before is a key first step in recognizing elevated risk.

2. Mobility or physical function problems

The source also notes that physical function or mobility limitation problems, whether measured objectively or reported by the patient, were commonly used to identify higher-risk groups in studies. Difficulty walking, balance problems, or reduced functional mobility can therefore signal increased fall risk.

3. Timed Up and Go test

USPSTF Recommendation Statement: Interventions to Prevent Falls in Community-Dwelling Older Adults (JAMA, 2018) states that clinicians may also use assessments of gait and mobility, such as the Timed Up and Go test. This test helps evaluate how well an older adult can stand up, walk, turn, and sit down, giving clinicians a practical way to assess gait and mobility concerns linked to falls.

Key takeaway

• Falls are a major health burden in older adults, with 28.7% reporting a fall, about 29 million falls, 37.5% causing medical treatment or activity restriction, and about 33,000 deaths.
• The recommendation covers community-dwelling adults age 65 years or older.
• Increased fall risk is identified mainly through history of falls, mobility or physical function problems, and gait/mobility assessment tools such as the Timed Up and Go test.