A new study contradicts the accepted wisdom of ‘when’ and ‘where’. Fall risk for older adults peaks in the winter, with outdoor falls in the ice and snow. Wrong. A new study presented at the recent Anesthesiology 2017 meeting of the American Society of Anesthesiologists found that hip fractures peaked during the warmer months at 55 percent.
- The leading months were May (10.5 percent), September (10.3 percent), and October (9.7 percent)
- Over 76 percent of those fractures occurred indoors while tripping over an obstacle like throw rugs or falling out of bed
- Outdoor fractures in warm months were led by trips over obstacles, with the second and third leading causes being struck by or falling from a vehicle (!) or falling on or down stairs
The study sampled 544 patients treated at The Hospital of Central Connecticut for hip fracture from 2013 to 2016, with warm months defined as May 1 through October 31. Study author Jason Guercio, MD, MBA concluded that “Given the results of this study, it appears that efforts to decrease fall risk among the elderly living in cold climates should not be preferentially aimed at preventing outdoor fractures in winter, but should focus on conditions present throughout the year, and most importantly on mitigating indoor risk.” For caregivers, another reason why hazards in walking areas have to be reviewed and minimized.
The information provided does not give any indication as to the patient activity when the accident happened. There was also no correlation with health conditions or time. For instance, other studies have pointed out that a person rising out of bed in the morning has a change of blood pressure (high and low), and in the middle of the night, that person may be half-asleep.
Where does technology come in? Getting ahead of the curve via gait analytics to alert for changes in gait and difficulty in walking. Noticing those changes could lead to proactive care and prevention. But as of now, those systems are either in test (Xsens MVN BIOMECH, WiGait TTA 4 May, Carnegie-Mellon TTA 23 May 16, Tiger Place MU TTA 29 Aug 15) or in early days in assisted living (CarePredict)–which doesn’t much help older adults at home. ASA release, McKnight’s Senior Living