Actor Robert Culp dies after a fall.

Robert Culp, 79, has died. The actor is best known for his roles in the 60’s TV show I Spy, in which he co-starred with Bill Cosby, and more recently as the father-in-law, Warren Whelan, on Everybody Loves Raymond. Culp had apparently fallen on a sidewalk outside a Los Angeles park. It was unclear whether the fall had caused his death, or whether a medical condition (such as a heart attack or stroke) had caused the actor to fall. An autopsy is planned.

Falls in the elderly is a major health issue, especially as the baby-boomer generation ages.

According to the CDC:

  • More than one third of adults 65 and older fall each year in the United States.
  • Among older adults, falls are the leading cause of injury deaths. They are also the most common cause of nonfatal injuries and hospital admissions for trauma.
  • In 2005, 15,800 people 65 and older died from injuries related to unintentional falls; about 1.8 million people 65 and older were treated in emergency departments for nonfatal injuries from falls, and more than 433,000 of these patients were hospitalized.
  • The rates of fall-related deaths among older adults rose significantly over the past decade.

What outcomes are linked to falls?

  • Twenty percent to 30% of people who fall suffer moderate to severe injuries such as bruises, hip fractures, or head traumas. These injuries can make it hard to get around and limit independent living. They also can increase the risk of early death.
  • Falls are the most common cause of traumatic brain injuries, or TBI. In 2000, TBI accounted for 46% of fatal falls among older adults.
  • Most fractures among older adults are caused by falls , with the most common fractures being of the spine, hip, forearm, leg, ankle, pelvis, upper arm, and hand.
  • Many people who fall, even those who are not injured, develop a fear of falling. This fear may cause them to limit their activities, leading to reduced mobility and physical fitness, and increasing their actual risk of falling.
  • In 2000, direct medical costs totaled $179 million for fatal falls and $19 billion for nonfatal fall injuries.

Who is at risk?

  • Men are more likely to die from a fall. After adjusting for age, the fall fatality rate in 2004 was 49% higher for men than for women.
  • Women are 67% more likely than men to have a nonfatal fall injury, with fall-related fractures twice as high for women as for men. Women account for over 70% of hospital admissions for hip fractures.
  • The risk of being seriously injured in a fall increases with age.  Adults over 85 were four to five times more likely to fall than adults 65 to 74.
  • Nearly 85% of deaths from falls in 2004 were among people 75 and older.
  • People 75 and older who fall are four to five times more likely to be admitted to a long-term care facility for a year or longer.
  • There is little difference in fatal fall rates between whites and blacks, ages 65 to 74 . After age 75, white men have the highest fatality rates, followed by white women, black men, and black women.

How can older adults prevent falls?

Older adults can take several steps to protect their independence and reduce their risk of falling. They can:

  • Exercise regularly; exercise programs like Tai Chi that increase strength and improve balance are especially good.
  • Ask their doctor or pharmacist to review their medicines–both prescription and over-the counter–to reduce side effects and interactions.
  • Have their eyes checked by an eye doctor at least once a year.
  • Improve the lighting in their home, and outdoors on walkways around the home.
  • Reduce hazards inside and outside their home that can lead to falls.
Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

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