(1589) Rising Fall-Related Mortality in the Elderly Population

Introduction: Every year 36 million elderly adults (age > 65 years) fall in the United States, with annual medical costs at nearly $50 billion. It has also been shown that fall-related mortality among the elderly has risen significantly over the last 20 years. However, the impact of age on fall-related mortality among this group [especially the super-elderly (age > 85 years)], as well as mechanisms of fall-related mortality, have not been clearly defined. To address these gaps, our objectives were to: 1) Examine age stratified trends in fall-related mortality among the elderly population and 2) Describe the mechanisms contributing to fall-related mortality in the elderly.

Methods: We conducted a cross-sectional study utilizing the Center of Disease Control’s Wide-ranging Online Data for Epidemiologic Research (WONDER) platform from 1999-2020. We examined the yearly trends in the rate of fall-related mortality (ascertained by International Classification of Disease, 10th revision, codes) among the elderly US population (age > 65 years) in 10-year age groups (65-74, 75-84, 85+). Additionally, we examined fall mechanisms among fall-related mortalities in the elderly. Multivariable regression models were used to examine the association of time (year) with fall-related mortality.

Results: Among 65-74 year-old Americans, the crude rate (per 100,000) of fall-related mortality was 9 in 1999 and 18.2 in 2020. Among 75-84 year-old Americans, the crude rate (per 100,000) of fall-related mortality was 31.5 in 1999 and 67.9 in 2020. Among 85+ year-old Americans the crude rate (per 100,000) of fall-related mortality was 110.2 in 1999 and 291.5 in 2020. The primary mechanism of fall-related mortality across all age strata and years were ground-level falls. Fall-related mortality increased over each year in the elderly (1.73, 95% CI 1.56 - 1.89, p < 0.0001).

Conclusions: Fall-related mortality burden in the elderly has doubled in the last 20 years, especially in the super-elderly (age>85). Ground-level falls account for a majority of fall-related mortality falls among the elderly in the United States. Future research and public policy efforts should be directed at reducing the risks of falls in the elderly, especially the super-elderly.