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From nocturnal landslides on the way from toilets to outdoor accidents, more and more elderly Americans are dying after a fall and the risk has doubled since 2000, according to a study released Tuesday.
The figures confirm a trend also observed in Europe.
In the United States, the absolute number of deaths among people over 75 nearly tripled between 2000 and 2016 (8,613 to 25,189).
According to a study published in the Journal of the American Medical Association (JAMA), the death rate among men and women has doubled.
The research was conducted by Klaas Hartholt at Reinier de Graaf Groep in the Netherlands.
"About one in three people aged 65 or older falls each year," wrote Marco Pahor, director of the Institute on Aging at the University of Florida, in an editorial on the subject.
"The fall is a potentially catastrophic and potentially fatal event for the elderly."
High cost
But the risk of death due to trauma to the head and internal bleeding is not limited. Fractures in the hips, knees and ankles can mark the beginning of a vicious circle: hospitalization, loss of independence, physical rehabilitation and long-term effects on morale and mental health.
According to Atul Gawande, doctor and author of the book "Being Mortal", one in five people who fracture their hips will never walk again.
In the United States, fall-related costs are among the most expensive categories for hospital care.
"Falls represent a major emerging epidemic among the elderly," Pahor told AFP.
In the Netherlands, Spain, Australia and Canada, where falls have also been studied recently, the trend has been the same since 2000. In France, the problem is described as a "major public health problem".
Links to medicines
The reasons for the rise have not been well studied, but geriatricians have some ideas.
It is possible that today's seniors are more active than those of the past. The increase in the rate of obesity could also play a role, because it is linked to a weakening of the muscles.
Perhaps most importantly, although modern medicine has been successful in improving the treatment of chronic diseases, it has neglected the quality of life of older people.
"Unfortunately, some medications can increase the risk of falling," AFP Elizabeth Burns, a health scientist with the Centers for Disease and Control, told JAMA.
"Some drugs, such as psychoactive drugs, can cause side effects such as blurred vision, confusion and drowsiness," she said, adding that the use of these drugs, including opioids, had increased significantly in recent years.
George Taler, a Geriatrician at the MedStar Washington Hospital Center who makes home visits to the US capital, added that the method he favored the most to reduce the risk of falling was simple: "disordering" medications that had become useless .
Studies have shown that when the number of prescription drugs consumed daily is four or more, dizziness and loss of balance increase dramatically.
"We know very well how to write prescriptions for drugs – we are not as good at taking them, even if they are no longer useful or necessary," Taler told AFP.
"I am going to give you a case today: it is about an elderly woman who has had several falls and who has swollen ankles.
"Well, if I gave her a prescription for a diuretic to get rid of the swelling and all the fluid goes away, she might fall from dehydration, so we have to adapt the drug to her reality. "
Physical exercise
Another study published in JAMA under the direction of Teresa Liu-Ambrose of the University of British Columbia found that physical exercise helped reduce falls.
In a relatively small experiment conducted in the Greater Vancouver area with about 300 septuagenarians, researchers tested the effectiveness of the Otago Exercise Program, a home-based program overseen by a physiotherapist.
It includes many exercises to strengthen the muscles of the knees, hips and ankles as well as balance exercises (including backing, standing on one leg, etc.), repeated three times a week, participants are invited to walk 30 minutes at least twice a week. .
The physiotherapist went at various intervals to stay on course, his fifth and last visit six months after the start of the program.
The program "significantly reduces the rate of subsequent falls" compared to those in a control group, but the researchers warned that the results required replication in other clinical settings.
The researchers were intrigued by the benefits of physical exercise, even if it did not increase muscle mbad.
"The simple fact of doing exercise makes people more aware of their body, their space, feels better about themselves," said Taler. "And while we may not be able to measure this, it still has measurable benefits in terms of falls."
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