Falls more dangerous than firearms

Older Alaskans and the families of such take notice: The bedroom, bathroom and stairs at home are statically more dangerous to health than the firearms there.

That just in from the BMJ’s open journal on Trauma Care and Surgery with a headline proclaiming “Geriatric falls: an enormous economic burden compared to firearms.”

The headline is posted above a study conducted by a group of doctors from the Westchester Medical Center in Valhalla, New York, who found “that while combined costs of fatal firearm injuries still surpassed those of fatal falls overall, the combined cost of fatal falls for the 45–85 age group exceeded fatal firearm injuries. This finding is particularly important since it demonstrates how changing demographics affect the economic burden of healthcare in society.”

More than 70 percent of the serious falls among those over age 70 have been reported to happen indoors, almost 80 percent of those in the home, with the most common locations for a fall the bedroom, bathroom, and stairs.

A couple of things are going on here the researchers concluded, one of them being the broad general decline in fitness in a country where physical activity is largely gone from daily life. Since Henry Ford brought the Model T to market in 1908, the United States has become home to an evermore mechanized society.

Many Americans are now inextricably tied to machines from the motor vehicles that take them everywhere to the equipment they use for “recreation” to motorized grocery carts to power them around supermarkets and shopping centers.

“It is a known fact that the elderly population inherits multiple comorbidities and is susceptible to polypharmacy that makes them physiologically weaker,” the researchers noted,

The physiological weakness associated with age isn’t, however, something intrinsically linked to inheritance. A 2022 metaanalysis of “frailty” in the elderly found a fundamental lack of physical activity playing a big part.

You sit; you pay

“A higher level of physical activity was associated with 41 percent decreased odds of frailty,” the authors of that study wrote. “The result of our study was consistent with other reports, which showed that a higher level of physical activity was beneficial to physical function, muscle strength, and cognitive function.”

At a societal level, the costs of the fragility of the elderly who’ve spent too much of their lives sitting is now compounded by their increase in number.

“Between 2010 and 2020, the 65+ population experienced its fastest growth rate, increasing by 38.6 percent from 40.3 million to 55.8 million,” the authors of the study published by what used to be known as the British Medical Journal (BMJ) wrote. “The older population reached 55.8 million or 16.8 percent of the population of the USA in 2020. Specifically, the age group of 75 to 84 years consisted of 16.3 million individuals in 2020, and this number is expected to rise as more baby boomers enter this age bracket. This demographic shift inherently exposes a larger number of people to a heightened risk of falls.

“A comparison of the combined costs in people aged 45 to 85+ years old caused by falls and firearms reveals a significant shift in the relationship over time,” they added. “The firearm injuries in this demographic were predominantly of suicidal intent. While firearm injuries accounted for higher combined costs until 2019, fatal falls surpassed them in economic impact thereafter.”

Suicide is without doubt a firearm-related concern here.

The National Council on Aging has described suicide among the American elderly, especially older men, as “a growing public health crisis,” noting that ‘while older adults comprise just 16.8 percent of the population, they make up approximately 22 percent of suicides.”

And old, white men are grossly over-represented in that 22 percent.

“(Old), non-Hispanic, white men have the highest suicide rate” in the nation at 50.1 per 100,000, according to the Centers for Disease Control. This compares to rates of 42.2 per 100,000 for all men 75 and older and 41.3 per 100,000 for American Indians and Alaska Natives in general.

The overall, average suicide rate in the U.S. is about 14 per 100,000 but with a huge difference between males at 22.8 per 100,000 and females at 5.7 per 100,000,” according to the National Institute of Mental Health.  About 55 percent of suicides are committed with firearms.

Firearms deaths are, as the BMJ researchers pointed out, a hot-button issue in the U.S.

“While public discourse often places an emphasis on issues such as gun violence because of its acuteness, our study underscores the hidden economic burden of geriatric falls,” they wrote. “It is noteworthy that geriatric falls not only result in physical harm but also lead to a cascade of medical expenses. From emergency room visits to hospital stays, surgeries, and post-treatment rehabilitation, the comprehensive healthcare journey following a fall can be extensive and costly. Moreover, falls can lead to chronic health conditions that require ongoing medical management, leading to a sustained financial burden on both individuals and healthcare systems.”

Whether younger Americans care about any of this is an unknown, but the researchers said their data should provide “a clarion call for policymakers.

“The data illuminates the need for comprehensive policies that cater to the unique healthcare needs of the elderly population. Public health strategies should be formulated to address fall prevention, promote active lifestyles, and provide adequate support for older adults. These policies can range from creating age-friendly environments to ensuring accessible healthcare services that can effectively address the growing demand.”

Individual responsibilities

“Healthcare” in the U.S. has, unfortunately, become too often synonymous with “medicine” when in this case the suggested promotion of “active lifestyles” might well produce the greatest health benefit.

The CDC has specifically cited the “physical activity benefits for adults 65 or older,” arguing that even “a single session of moderate to vigorous physical activity provides immediate benefits for your health.”

And physical activity pays big health dividends on the way to 65, not just after it, although the CDC does specifically cite one of the benefits for those 65 and older as improvements in balance and coordination that “reduce risks of falls.”

But there are a lot of other immediate and long-term benefits, according to the federal agency:

Immediate

• Sleep: improves sleep quality.
• Less Anxiety: reduces feelings of anxiety.
• Blood Pressure: reduces blood pressure.

Long-term

• Brain Health: reduces risks of developing dementia (including Alzheimer’s disease) and reduces risk of depression.
• Heart Health: lowers risk of heart disease, stroke, and type 2 diabetes.
• Cancer Prevention: lowers risk of 8 cancers (bladder, breast, colon, endometrium, esophagus, kidney, lung, and stomach).
• Healthy Weight: reduces risk of weight gain.
• Independent Living: helps people live independently longer.
• Bone Strength: improves bone health.
• Emerging research suggests physical activity may also help boost immune function.

The first item on that list is notable with many medical researchers now talking about “the growing epidemic of Alzheimer’s disease.” and the association between depression and suicide.

“Depression is the most common condition associated with suicide,” according to the American Foundation for Suicide Prevention. A major meta-analysis published by BMJ in January of this year reported that “exercise is an effective treatment for depression, with walking or jogging, yoga, and strength training more effective than other exercises, particularly when intense.

“Exercise appeared equally effective for people with and without comorbidities and with different baseline levels of depression.”

Meanwhile, the last item on that CDC list is notable in the wake of the global pandemic that struck most heavily at those suffering from immunosenescence, the decay of the immune system with time.

Polish researchers studying the “interaction of physical activity and overall immune profile” in 2021 reported finding a major link between physical activity and increased levels of T cells in older adults and “concluded that lifestyle exercise could lead to rejuvenation of the immune system by increasing the percentage of naïve T” cells.

Naive T cells played a major role in determining who survived the infection with the newly evolved SARS-CoV-2 virus that caused the disease known as Covid-19 and researchers have since reported that reductions “in naive T cells and T cell repertoire contraction have been linked to poor response to vaccination, and elderly individuals with low frequencies of naive T cell fractions tend to contract severe COVID-19 infection.”

One might almost conclude from all of this collectively that just spending too much time sitting on your ass at home is far more dangerous to your health than having firearms in the house.,