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Elderly in Care Residences At High Risk of Head Injuries

Update Date: Oct 07, 2013 12:49 PM EDT

Older adults living in long-term care facilities are at high risk of head injuries, according to a new study.

New research reveals that falls account for more than 60 percent of hospital stays for traumatic brain injury in seniors over 65 years of age, and that 37 percent experience head impact in falls. Researchers say that the incidence is increasing, especially in those over the age of 80.

"Recent studies have documented a rapid increase among older adults in age-adjusted rates for fall-related head injuries, especially in the long-term care environment," researchers wrote in the study. "The reasons for these trends are poorly understood."

Lead researcher Stephen Robinovitch, Simon Fraser University, in Canada wanted to understand why falls result in head injury. They looked at video footage of 227 falls in 133 residents of a long-term care facility.

Robinovitch and his team found that people struck their heads in 37 percent of the falls.  People hit their heads on the ground in 63 percent of cases, the wall in 13 percent of cases and furniture in 16 percent of cases. Researchers found that most falls to the floor hit hard flooring like tile or linoleum.

"We found that head impact occurred in 37 percent of falls," researchers wrote. "By any measure, this is an alarmingly high prevalence."

Researchers noted that head impact is rare in falls in young people.

After analyzing the factors associated with the head impact in residents of long-term care facilities, researchers found that the likelihood for head impact was significantly higher for forward falls than backward falls. Furthermore, attempts to use arms and legs to break the fall were ineffective. Researchers noted that hand impact occurred in 47 percent of falls in older people.

"Although we cannot identify why hand impact was generally ineffective in halting downward movement and preventing head impact, likely causes include ineffective arm placement; nonoptimal muscle tone or muscle activation at impact; and insufficient strength in upper-limb, neck and trunk muscles, which is amenable to improvement through resistance training," researchers explained.

The findings are published in the journal CMAJ (Canadian Medical Association Journal)

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