Senate Committee on Aging

NSC Statement: Senate Special Committee on Aging

Falls Prevention: National, State and Local Solutions to Better Support Seniors
Oct. 16, 2019

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The National Safety Council (NSC) is a nonprofit organization with a century-long mission of eliminating preventable deaths at work, in homes and on the road through leadership, research, education and advocacy. Our more than 15,000 member companies represent employees at more than 50,000 U.S. worksites.

According to National Safety Council Injury Facts® falls are currently the third leading cause of preventable death. In 2017, 31,190 older adults aged 65 and older died from preventable falls, and more than 3 million were treated in emergency departments. Over the past 10 years, the number of older adult fall deaths has increased 58%, while emergency department visits have increased 40%.Today, an older adult dies from a fall every 19 minutes. According to the Centers for Disease Control and Prevention (CDC), more than one in four older adults report a fall each year.

Fall injuries are among the 20 most expensive medical conditions, and government-funded programs, such as Medicare and Medicaid, finance about 75% of these costs. As the American population continues to age, and with 10,000 people in the United States turning 65 every day, we could expect to see 49 million falls, 12 million fall injuries and almost 100,000 fall-related deaths per year by 2030.

According to CDC, the financial cost to the nation is $31 billion annually in Medicare spending alone to treat these injuries. However, while falls represent the leading cause of preventable death among adults 65 years of age and older, they are not an inevitable part of aging in America and are on the whole, preventable.

In order to address fall prevention for older Americans, the National Safety Council has previously urged Congress to support $4 million to the CDC National Center for Injury Prevention and Control programming and research to prevent older adult falls and $10 million to the Administration for Community Living (ACL) engagement of the aging services network to implement and sustain evidence-based falls prevention programs, in conjunction with leading advocacy and support organizations nationwide. A copy of this letter is attached.

Older adult falls may be best addressed by providing evidence-based falls prevention programs in communities, and through identification of specific risk factors that older adults may face. More than 90% of older adults see a medical provider at least once a year, and many of these individuals see their pharmacists even more frequently. Clinicians and pharmacists can both serve as critical resources to help inform and empower older adults to address one or more specific fall risk factors.

The National Safety Council supports the CDC STEADI (Stopping Elderly Accidents Deaths and Injuries) program to help all healthcare providers make fall prevention a routine part of clinical care. STEADI includes a coordinated care plan that offers healthcare providers a 12-step framework to manage older patients’ fall risk.

Given that certain medications can increase fall risk, CDC also created STEADI Rx to engage with community pharmacists and coordinate on falls prevention efforts. STEADI-Rx offers tools for pharmacists on how to screen, assess, and coordinate care to reduce older adult fall risk.

There are other steps to take to reduce chances of a fall. A review of 54 randomized clinical trials found that the combination of exercise and vision assessment and treatment likely has the strongest association with decreasing fall injuries among older adults. A 2015 CDC study assessing the cost-benefit analysis of three older adult fall-prevention programs identified a positive return on investment for all three programs. The three programs demonstrated that the cost of decreased direct medical costs was greater than the costs associated with implementing the program. Two programs focused either on Tai Chi or improving balance and administered to persons age 80 and older resulted in a greater than 100% return on investment. A similar 2015 study found that adults who consistently participate in exercise programs can reduce their risk of experiencing a medically treated fall by 20% to 30%.

Preventing and reducing falls lowers healthcare spending, improves health and fosters independence. Congress should lead by providing necessary funding to the CDC and ACL and publicizing already available resources such as STEADI.

While we all are aging every day, falls do not have to be a part of that process. Understanding fall risks is the first step to keeping our loved ones and ourselves safe. Thank you for the opportunity to share this testimony, and for supporting a national conversation that will help older Americans lead their fullest lives.