Mortality from accidental falls among the elderly in the United States, 1962-1988: demonstrating the impact of improved trauma management.

Falls in elderly persons primarily occur because of increasing intrinsic frailty rather than extrinsic environmental hazards. Thus declining mortality from accidental falls in the elderly predominantly reflects improved trauma management rather than injury prevention. Mortality attributed to accidental falls among individuals aged 60 to 85 years in the United States from 1962 through 1988 was analyzed using the Strehler-Mildvan modification of the Gompertz relationship of aging and mortality. This method of analysis can be used to define a disorder-specific age at which etiopathogenic influences are directly proportional to the mortality rate. From 1962 through 1988, the mortality rates (per 100,000) from accidental falls in the United States declined 63.5% (from 165.6 to 60.4) among men at age 83.4 years, and declined 76.3% (from 86.2 to 20.4) among women at age 77.5 years. This analysis suggests that trauma management, at the population level, was 2.74 times more effective in men and 4.22 times more effective in women at reducing mortality from accidental falls among the elderly in 1988 than in 1962.