By Amy VanderZanden, special to Humanosphere
Along with icy forecasts and winter weather, the dangers faced by elderly Americans from falls has received wide coverage recently.
We’ve learned that falls are the leading cause of death for elderly Americans, and that this is due in part to the shrinkage of people’s brains as they age – leading to extra risk of “jostling” from falls. In the US, fall prevention has become a major priority for nursing homes nationwide, and the National Institute on Aging has recently embarked on a $30 million dollar study on reducing fall injuries.
Globally, over 500,000 people died as a result of falls in 2013. Close to 400,000 of those people – more than 70% of all deaths from falls – were in developing countries.
Falls have reached the top 10 causes of death in countries including Norway, Switzerland, and Finland, and these countries have some of the highest rates of deaths from falls worldwide, over 20 per 100,000. But when we standardize the rates to make them comparable across all countries, the story begins to change.
Countries in South Asia and sub-Saharan Africa are facing increasingly large numbers of deaths from falls. Bangladesh, Myanmar, and Zimbabwe have some of the highest age-standardized rates of deaths from falls anywhere. And in Bangladesh, there were twice as many deaths per 100,000 from falls as in France.
Probability of death from falls among 50-74 year old population, 2013
Notes: Source: Global Burden of Disease Study 2013. To explore the data visualization online, go to http://ihmeuw.org/2xj8.
The map above shows the elevated risk of death from falls among older people worldwide. Brighter shading indicates higher risk, and some of the brightest colors are in Bangldesh, India, Ethiopia, Zimbabwe, and Burkina Faso.
While the overall percentage of deaths from accidental injuries has decreased in developing countries since the 1990s and early 2000s, the proportion of deaths caused by falls has actually increased – especially among older age groups.
The total number of people dying each year from falls globally has increased by nearly two-thirds since 1990. It increased even faster in developing countries, indicating that these countries face an increasingly disproportionate share of this cause of death.
Proportion of deaths caused by unintentional injuries in developing countries, 1990 and 2010
Notes: Source: Global Burden of Disease Study 2010. To explore the data visualization online, go to http://ihmeuw.org/2xja.
Factors that increase the risk of falling among elderly people everywhere include uneven surfaces, clutter, and footwear that impairs the ability to walk safely – things that are relatively easy to fix in countries with paved sidewalks, easy access to sneakers, and accessibility requirements around infrastructure construction. In many low-resource settings, however, these sorts of interventions can be much more challenging to implement.
According to a World Health Organization case study on prevention of falls in older persons, “apart from South Africa, no…African countries provide guidelines for the management and prevention of falls in the elderly [and]despite the availability of the guidelines and a booklet, there is no evidence of their employment in the South African target population.” As populations everywhere continue to live to older ages, the challenges brought about by falls are likely to continue to increase as well.