An Introduction to the Centers for Disease Control and Prevention’s Efforts to Prevent Older Adult Falls

The Centers for Disease Control and Prevention’s National Center for Injury Prevention and Control (CDC) envisions a society where older adults (persons 65 and older) can live long, safe, and healthy lives. Falls are a threat to older adults’ health and can significantly limit their ability to live independently. One in three older adults falls each year, resulting in over $30 billion in direct medical costs (1). For more than 20 years, CDC has been conducting research to help prevent falls and resulting injuries among older adults. Research has identified important and modifiable risk factors. These include muscle weakness, gait and balance problems, psychoactive medication use, poor vision, and environmental hazards (2). Building on this knowledge, various falls interventions have been developed and tested. A recent Cochrane Review (3) identified 159 randomized controlled trials (RCT) of falls interventions that included nearly 80,000 participants. This meta-analysis found that group exercise programs (e.g., Tai Chi), home-based exercise programs (e.g., Otago), and home safety modifications (e.g., installing bathroom grab bars), combined with behavioral changes recommended by an occupational therapist, significantly reduced falls among older adults. Implementing these interventions on a large scale and increasing older adults’ access to these interventions can prevent a substantial number of falls and fall-related injuries. Medical providers can play an important role by identifying older adults who are likely to fall and providing clinical preventive services to help reduce fall risks. To aid medical providers, the American and British Geriatrics Societies (AGS/BGS) developed a clinical practice guideline that (1) encourages providers to conduct fall risk assessments to identify patients who are at risk of falling and (2) describes evidence-based interventions that can be incorporated into a patient’s plan of care (4). Recommended interventions include interventions delivered in clinical settings, (e.g., medication review and modification, gait and balance assessment with referral to physical therapy), as well as participation in community-based fall prevention programs. Linking clinical medicine to community fall prevention programs can be an important step in improving uptake of evidence-based practices to prevent older adult falls. Based on this information, CDC developed a fall prevention approach that integrates clinical practice and evidence-based community fall prevention programs. The approach expands current health care practice by supporting providers in making fall prevention a routine part of clinical care and encouraging providers to link clinical practice with community-based fall prevention programs. To this end, CDC’s Injury Center provides targeted technical and programmatic assistance to several state health departments and medical providers to help them implement fall prevention programs and measure impact.