Winter weather alerts may signal greater fall risk for elderly

(Reuters Health) - In Canadian winters, older people fall 20 percent more often after a freezing rain alert, according to a new study.

An Ultra-Orthodox Jewish man looks out of a fogged up bus window in Jerusalem January 9, 2013. REUTERS/Baz Ratner

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.

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: Age and Ageing, online December 19, 2014.