Falls the leading cause of injury and death in over-65s

More than 400 older Australians are hospitalised every day because of a fall, and an average of 17 of those people will die as a result.

Falls cost the health system more than three billion dollars a year, making them one of Australia’s most significant and preventable health burdens. For those over 65, falls are the leading cause of injury resulting in hospital admissions and are also the leading cause of death.

During April Falls Month, researchers are urging health and aged care workers to intensify fall prevention efforts and help older people build the balance and strength needed to stay safe.

Professor Stephen Lord, director of Neuroscience Research Australia’s (NeuRA) Falls, Balance and Injury Research Centre, said falls remain a major healthcare problem, particularly as the population ages.

“On average, one in three older people will fall each year, and about half of those will fall more than once,” Professor Lord said.

“Most falls do not cause injury, but a significant proportion do, and they can be severe and life changing.”

Hip fractures, wrist fractures and head trauma are among the most common injuries, but Professor Lord said the psychological impact can be just as damaging.

“A fall can take away someone’s confidence, their independence, and their ability to live at home. It is a major issue for older people and for the healthcare system that must care for them.”

Why are falls are rising?

Explaining the continued rise in fall incidents and hospitalisations is not a simple task, Professor Lord said the plethora of intertwining risk factors makes pinpointing the cause a difficult task.

“An ageing population explains part of it, but not all,” he said.

“Even within the 65 plus group, the average age is rising, so we have more people living into their 80s and 90s.”

He said lifestyle changes, including increased sedentary behaviour, may be contributing, but evidence is still emerging.

“It is likely that prevention programs are not reaching enough people. We need to do more to help older adults minimise their risk.”

What health and aged care workers can do now

Professor Lord emphasised that the Australian Commission on Safety and Quality in Health Care’s national falls guidelines remain the most important resource for health workers.

“The guidelines summarise all the strategies that can be put into effect,” he said.

“They are designed for healthcare workers to work with older people to minimise risk.”

The most effective intervention remains exercise, particularly balance training.

“Balance is the key,” Professor Lord said.

“Improving balance, strength and mobility through targeted exercises is one of the best ways to reduce fall risk. The evidence shows it works across community settings, residential aged care and in people with conditions like stroke or Parkinson’s disease.”

He said aged care workers should also consider other risk factors, including:

• cognitive impairment
• continence issues
• poor footwear
• medication side effects
• vision problems and outdated prescriptions.

“It is a multifactorial puzzle,” Professor Lord said.

“We need to make sure people are working at their best.”

Balance: the third pillar of exercise

Professor Lord said many people think of exercise as strength and cardio, but balance is just as important, especially as we age.

“The United Nations now recognises balance as the third pillar of physical activity for older people,” he said.

Simple exercises, such as standing with feet together, standing on one leg near a support, or practising stepping patterns, can make a significant difference.

One of the biggest challenges in fall prevention is keeping older adults engaged in exercise programs. Digital health tools are emerging as a promising solution.

“People know exercise is good for them, but they often find it boring,” Professor Lord said.

Inspired by popular video game Dance Dance Revolution, NeuRA has developed a step-training system that uses a mat and simple challenges, from stepping on cockroaches to avoiding aliens, to improve reaction time, balance and stepping accuracy.

“We have shown in community groups that these games can reduce falls by about 25 per cent,” Professor Lord said.

“We are now adapting them for residential aged care settings so people can play in common rooms.”

A reminder to act

Professor Lord said April Falls Month is an opportunity for health and aged care workers to reinforce prevention messages and encourage older people to be proactive.

“Falls are common, but they are not inevitable,” he said.

“With the right strategies, we can reduce risk and help older Australians maintain independence and quality of life.”

He encouraged clinicians to share the national falls guidelines with colleagues and families.

“The key messages are all in the guidelines,” he said.

“They are the best resource we have.”