Falls (health and wellbeing needs in South Tyneside)

Falls and fall-related injuries are a common and serious problem for older people.

• According to the latest Cochrane Review on falls, "About a third of community-dwelling people over 65 years old fall each year (Campbell 1990; Tinetti 1988), and the rate of all related injuries increases with age (Peel 2002).
• Falls can have serious consequences, e.g. fractures and head injuries (Peel 2002). Around 10% of falls result in a fracture (Campbell 1990; Tinetti 1988); fall-associated fractures in older people are a significant source of morbidity and mortality (Keene 1993).
• About 15%of falls result from an external event that would cause most people to fall, a similar proportion have a single identifiable cause such as syncope, and the remainder result from multiple interacting factors (Campbell 2006).
• Since many risk factors appear to interact in those who suffer fall related fractures (Cummings 1995), it is not clear to what extent interventions designed to prevent falls will also prevent hip or other fall-associated fractures.
• Falls can also have psychological consequences: fear of falling and loss of confidence that can result in self restricted activity levels leading to a reduction in physical function and social interactions (Yardley 2002). Falling puts a strain on the family and is an independent predictor of admission to a nursing home (Tinetti 1997)."

Public Health England's guidance on falls gives information specific to the nation:

• The Public Health Outcomes Framework reported that in 2013 to 2014 there were around 255,000 emergency hospital admissions related to falls among patients aged 65 and over, with around 173,000 (68%) of these patients aged 80 and over.
• Falls were the ninth highest cause of disability adjusted life years (DALYs) in England in 2013 and the highest cause of injury.

Short and long-term outlooks for patients are generally poor following a hip fracture, with an increased risk of dying in the following 12 months of between 18% and 33% and negative effects on daily living activities such as shopping and walking. A review of long-term disability found that around 20% of hip fracture patients entered long-term care in the first year after fracture.

The economic burden of incident and previous fragility fractures, those that result from mechanical forces that would not ordinarily result in fracture (equivalent to a fall from a standing height or less) in the UK is estimated as being £3.5 billion in 2010. 74% of these costs relate to incident fractures (ie health care), 24% relate to long-term (social) care and 2% to pharmacological prevention. (PHE, 2015)