Dedication

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• Acknowledgements
• Foreword
• Statistics on Seniors' Falls

The Division of Aging and Seniors dedicates this document to the memory of Margery Boyce (1932-1997), who devoted over two decades to the field of aging and seniors. She was a passionate advocate for all aspects of seniors' safety, and the inspiration for much of Health Canada's, and now the Public Health Agency of Canada's leadership in the area of seniors' falls prevention. Her deep concern for seniors is perpetuated in the work of the Division through its continued federal leadership on health issues related to aging and seniors.

Acknowledgements

The creation of this document has truly been a collective effort by many who share a commitment to seniors' falls prevention. The Public Health Agency of Canada wishes to thank all those who contributed their time and effort to the development, review and production of this document.

Special thanks to Jennette Toews, Policy Analyst, Division of Aging and Seniors, for her leadership and commitment to the research and analysis that led to the creation of this document.

Foreword

Most of us have heard of a senior who has fallen, been injured and suffered devastating effects: disability, chronic pain, loss of independence and a lesser quality of life. Such falls not only alter the course of aging, they also have serious repercussions on the lives of family and friends, and on Canada's public health resources.

Recognizing that falls are one of the most costly and complex injury issues facing seniors, the Public Health Agency of Canada (PHAC) has prepared this Report on Seniors' Falls in Canada to support and promote research, policies and programs to prevent seniors' falls. It is the first report to present comprehensive data on fall injuries and deaths, as well as evidence on risk factors and best practices for prevention, solely for Canadians age 65 years and over.

The development of this report was inspired by the unprecedented momentum and interest in seniors' falls prevention over the past decade in Canada and around the world. Health Canada and the Public Health Agency of Canada are proud of the work that has been carried out in the area of injury prevention and, in particular, of fall prevention among seniors.

The Report on Seniors' Falls in Canada provides information to support continued research and action to prevent falls and injuries among seniors in Canada. As surveillance, research and program initiatives expand, our collective understanding of risk factors and the prevention of falls will increase. This improved understanding holds promise for the development of effective new interventions and policies to reduce the human suffering and financial costs of falls and fall-related injuries among Canadian seniors.

David Butler-Jones, MD
MHSc, CCFP, FRCPC, FACPM
Chief Public Health Officer
Public Health Agency of Canada

Statistics on Seniors' Falls

• Falls are the second leading cause, after motor vehicle collisions, of injury-related hospitalizations for all ages, accounting for 29% of injury admissions.¹
• Seniors age 65 and over accounted for 40% of all injury hospitalizations, the largest proportion of all injury hospitalizations. Falls accounted for 85% of injury hospitalizations in this age group.²
• The fall-related injury rate is nine times greater among seniors than among those less than 65 years of age.³
• Almost half of seniors who fall experience a minor injury, and 5% to 25% sustain a serious injury such as a fracture or a sprain.⁴
• Falls cause more than 90% of all hip fractures in seniors and 20% die within a year of the fracture.⁵
• Families are often unable to provide care, and 40% of all nursing home admissions occur as a result of falls by older people.⁶
• Even without an injury, a fall can cause a loss in confidence and a curtailment of activities, which can lead to a decline in health and function and contribute to future falls with more serious outcomes.⁷
• A 20% reduction in falls would translate to an estimated 7,500 fewer hospitalizations and 1,800 fewer permanently disabled seniors. The overall national savings could amount to $138 million annually.⁸
• The magnitude of the problem of falls among older adults is reflected in the 300% increase in publications on the issue between 1985 and 2005.⁹

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1. Canadian Institute for Health Information. National trauma registry 2004 report: Injury hospitalizations (includes 2002-2003 data). Ottawa: 2004.

2. Canadian Institute for Health Information. National trauma 2003 registry report: Injury hospitalizations (includes 2001-2002 data). Ottawa: 2004.

3. Manitoba Health . Preventing falls and fall-related injuries in Manitoba: A review of best practices. Impact, 2005.

4. Alexander, B. H.; F. P. Rivara and M. E. Wolf. "The cost and frequency of hospitalization for fall-related injuries in older adults." American journal of public health, Vol. 82, No. 7, 1992, pp. 1020-23.
Nevitt, M.; S. Cummings and E. Hudes. "Risk factors for injurious falls: A prospective study." Journal of gerontology, Vol. 46, 1991, pp. M164-M170.

5. Tinetti, M. E. and C. S. Williams. "Falls, injuries due to falls, and the risk of admission to a nursing home." New England journal of medicine, Vol. 337, No. 18, 1997, pp. 1279-84..

6. Tinetti, M. E. et C. S. Williams. « Falls, injuries due to falls, and the risk of admission to a nursing home ». New England journal of medicine, vol. 337, n^o 18, 1997, pp. 1279-84.

7. Cumming, R. G. et al. "Prospective study of the impact of fear of falling on activities of daily living, SF-36 scores, and nursing home admission." Journal of gerontology, Vol. 55, No. 5, 2000, pp. M299-M305.

8. SMARTRISK. The economic burden of unintentional injury in Canada. 1998.

9. Close, J. C. "Prevention of falls: A time to translate evidence into practice." Age and ageing, Vol. 34, No. 2, 2005, pp. 98-100.

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