Falls - Age 65+ in District of Columbia

District of Columbia

Falls among older adults can lead to serious injuries with high medical costs and threaten their independence. In 2021, there were more than 38,700 deaths related to falls among older adults. The fatality rate from falls has been increasing, particularly among those age 85 and older.

Risk factors for falls include vitamin D deficiency, difficulty with walking and balance, use of certain medications, vision problems and hazards in the home, such as uneven steps.

Falls among older adults result in substantial medical costs. In 2015, the medical costs attributable to fatal and nonfatal falls were approximately $50 billion; Medicaid and Medicare covered 75% of those costs. It is estimated that these medical costs will double to more than $100 billion in 2030.

According to America’s Health Rankings analysis, the prevalence of falls is higher among:

• Older women than older men.
• American Indian/Alaska Native, multiracial and white older adults compared with Asian older adults, who have the lowest prevalence of all the measured racial and ethnic groups. 
• Older adults with an annual household income less than $25,000 compared with those with higher levels of income.
• Older adults living in non-metropolitan areas compared with those in metropolitan areas.

Actions older adults can take to prevent falls include:

• Asking a health care provider to evaluate their risk of falling.
• Talking with a doctor or pharmacist about medications that cause dizziness or drowsiness.
• Having annual eye exams and updating eyeglasses as needed.
• Getting screened for osteoporosis. 
• Participating in evidence-based physical activities to improve balance and strength, such as tai chi or A Matter of Balance, to improve balance and strength.
• Fixing hazards in the home.

Fall prevention education increases knowledge about avoiding falls and hip fractures and encourages older adults to stay active. The Centers for Disease Control and Prevention has created the Stopping Elderly Accidents, Deaths and Injuries (STEADI) initiative to help health care providers make fall prevention routine. STEADI is based on clinical guidelines and provides information and resources for patients, caregivers and members of the health care team. 

The National Council on Aging offers a Falls Free CheckUp tool, which can help an individual identify their fall risk and provides resources and tools to reduce the risk.

Healthy People 2030 has two objectives related to falls among older adults: 

• Reducing fall-related deaths among older adults.
• Reducing the rate of emergency department visits due to falls among older adults.

Florence, Curtis S., Gwen Bergen, Adam Atherly, Elizabeth Burns, Judy Stevens, and Cynthia Drake. “Medical Costs of Fatal and Nonfatal Falls in Older Adults.” Journal of the American Geriatrics Society 66, no. 4 (2018): 693–98. https://doi.org/10.1111/jgs.15304.

Garnett, Matthew. “QuickStats: Death Rates from Unintentional Falls Among Persons Aged ≥65 Years, by Age Group — National Vital Statistics System, United States, 1999–2018.” MMWR. Morbidity and Mortality Weekly Report 69, no. 45 (November 13, 2020): 1712. https://doi.org/10.15585/mmwr.mm6945a10.

Houry, Debra, Curtis Florence, Grant Baldwin, Judy Stevens, and Rod McClure. “The CDC Injury Center’s Response to the Growing Public Health Problem of Falls Among Older Adults.” American Journal of Lifestyle Medicine 10, no. 1 (January 2016): 74–77. https://doi.org/10.1177/1559827615600137.

Kakara, Ramakrishna, Gwen Bergen, Elizabeth Burns, and Mark Stevens. “Nonfatal and Fatal Falls Among Adults Aged ≥65 Years — United States, 2020–2021.” MMWR. Morbidity and Mortality Weekly Report 72, no. 35 (September 1, 2023): 938–43. https://doi.org/10.15585/mmwr.mm7235a1.