Fall of a "major epidemic" for older Americans



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(MENAFN – AFP) From the evening to the toilets to outdoor accidents, more and more Americans are dying after a fall, the risk doubling 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."

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.

– Fewer pills –

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".

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 more than anything, while modern medicine has done a good job of improving the treatment of chronic diseases, it has neglected the quality of life that older people can live.

According to George Taler, a geriatrician who runs the home visiting program at the MedStar Washington Hospital Center in the US capital.

One of the methods he favors the most to reduce the risk of falling is simple: "discourage" drugs that are no longer needed.

Studies have shown that when the number of prescription medications consumed daily is equal to or greater than four, disorientation and loss of balance increase dramatically.

"We know very well how to write prescriptions for medicines, we are not very good at removing them, even if they are no longer useful or necessary," he 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. "

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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