Epidemiology of Falls


  • 27% or 1 in 4 older adults falls each year
  • Every 20 minutes an older adult dies from a fall in the US


  • Falls cost the US healthcare system $50 billion each year
  • 75% of total falls cost are paid by Medicare and Medicaid


  • 27% of community-dwelling persons >65 and 50% of persons >80 fall each year
  • From 2005–2009, fall-related visits to the ED increased by almost 30%.
  • Falls are also on the rise.
    • Motor vehicle crash mortality rates have decreased in the last decade due to decreased severity of injuries and safer cars
  • Conversely, between 2002 and 2010
    • fall-related mortality increased by 46%
    • the number of fall-related injuries increased by 23%
  • In this age group, the mortality rate from falls now exceeds motor vehicle crashes and firearms injuries.


  • In 2000, there were 2.6 million nonfatal fall injuries with a total annual cost of $19 billon. Incidence of falls varied little with age, yet the cost of care doubled between ages 65–74 and 75–84.
  • For fatal falls, >10,000 occurred in 2000 with an estimated cost of $179 million. Both the incidence and cost increased with age and were nearly 20% more for women.
  • Cost-related calculations not accounted for in this study included the 12% of older adults who fell that subsequently required long-term nursing home care.
  • These calculations also do not account for costs associated with lost wages, informal caregivers, wheelchair ramps, reduced quality of life for the injured elder, or insurance claim processing costs.


  • Significant numbers of opportunities to intervene on modifiable risk factors are missed in the ED. One study showed that using current ED practice, we missed diagnosing 96% of modifiable risk factors in older ED patients presenting after a fall. Interestingly, in those that we did diagnose a risk factor, providers only occasionally intervened.
  • Teachable moment
  • Primary care providers might not know about the fall.


Burns ER et al. J Safety Res. 2016;58:99–103. Centers for Disease Control and Prevention. www.cdc.gov/steadi/. Accessed June 3, 2019. Allen SR et al. In: Luchette FA et al, eds. Geriatric Trauma and Critical Care. New York: Springer; 2017:247–253.

Kahn JH et al, eds. Geriatric Emergency Medicine: Principles and Practice. Cambridge University Press; 2014. Dalton T et al. JEMS. 2015. https://www.jems.com/articles/print/volume-40/issue-11/features/complexities-of-geriatric-trauma-patients.html. Accessed June 3, 2019. Sise RG et al. J Trauma Acute Care Surg. 2014;76(4):913–919.