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 That suggests a need for stronger cautions against going outside in
icy conditions and more help from local governments, families or
neighbors, according to the authors.
Those alerts "actually mean something," said David L. Buckeridge,
senior author of the study. "If you’re an older adult, it’s probably
better to take it easy for a day or two."
For certain people, bad weather "drastically increases their risk,”
said Buckeridge, an associate professor in the department of
Epidemiology, Biostatics and Occupational Health McGill University
in Montreal.
Previous research shows that about half of all falls among older
people happen when they're outside. So the study team decided to
look at how many of those outdoor falls took place during Canada’s
famously frigid and slippery winter weather.
The researchers analyzed emergency room data on patients in Montreal
from 1998 to 2006, comparing days with freezing rain alerts to days
with snowstorm alerts. Altogether they had injury reports for about
136,000 Montreal residents 65 and older.
When there was a freezing rain advisory in winter, there was an
overall 20 percent increase in falls among the elderly, they found.
The risks were especially high for people age 75 and older, and for
men.
Men were 31 percent more likely to fall on freezing rain alert days,
compared to other days, Buckeridge and his colleagues write in the
journal Age and Ageing.
Buckeridge said men might be more likely to go outside in bad
weather, or less careful or more prone to losing their balance when
they do venture out.
He noted that he, too, slipped and fell on an icy sidewalk after
moving from California to Quebec.
Overall, however, there was no difference in fall rates between
winter and other seasons. And the total rate of falls was higher
among the women than men.
But when the researchers looked at hazardous snowstorm alerts, they
saw a slight drop in fall-related injuries for both sexes.
Hip fractures happened at a similar rate whether there was freezing
rain or snow but were 12 percent more likely in winter versus the
rest of the year.
“Injuries are an important cause of morbidity and mortality, yet
they are often amenable to prevention through simple and effective
measures to modify human behavior and the environment,” Buckeridge
told Reuters Health.
He noted that 30 percent of older adults have at least one fall each
year, and nearly 25 percent of these result in serious injuries,
such as fractures, joint dislocations, lacerations and severe head
injuries.
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Dr. Michael McCloud, a geriatrician at the University of California,
Davis, said the association between falls and icy weather seemed
obvious. But the study does show that severe weather alerts might
provide a “window of opportunity” to reduce falls.
“Not only are fall-related injuries the leading cause of injury
death in older adults, but they often are the sentinel event in the
so-called cascade to dependency,” said McCloud, who was not involved
in the new study. “Beyond the personal devastation, falls-related
injuries have a significant societal cost,” he told Reuters Health
by email.
McCloud said about one in three people age 65 and older will fall
each year and about a quarter of those will have at least a
moderately severe injury. But, he said, there was no high quality
data on the number of falls caused by bad weather.
Buckeridge said he hoped the current data linking weather and risk
of falling would spur discussion of how to reduce falls.
He said public health officials could help older people avoid falls
by making them aware of freezing rain alerts, suggesting precautions
and urging relatives and neighbors to help. He said municipalities
could also spread salt on roads and sidewalks where high numbers of
older people live.
“It’s really all about being able to personalize that message and
make it more actionable,” Buckeridge said.
McCloud advises patients to use “secure footwear,” such as
deep-tread shoe and boot soles or removable traction cleats or hip
protectors and that they take smaller steps.
He also said older people should avoid multifocal eyeglasses when
walking outside in slippery weather, and avoid alcohol or sedating
medications beforehand.
Balance and leg strengthening exercise in the winter can also help,
McCloud said. Studies suggest that vitamin D supplementation
year-round might also help reduce fall-related injuries, he noted.
SOURCE: http://bit.ly/14cI1gt
Age and Ageing, online December 19, 2014.
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