Falls are the leading cause of both fatal and non-fatal injuries in older adults across the United States, also topping the charts for traumatic brain injuries. In 2021 alone, falls claimed the lives of 36,500 older Americans and 3,805 older residents of Florida. Research into the potential link between alcohol use and the severity of these incidents is limited, but existing studies suggest a possible connection. The scarcity of detailed investigations into how alcohol consumption affects the likelihood and severity of falls highlights a significant gap in our understanding of this issue.
Recognizing this knowledge gap, Florida Atlantic University’s Schmidt College of Medicine, in collaboration with other researchers, initiated one of the first studies to analyze the correlation between self-reported alcohol use and the incidence of severe head trauma among older individuals. Utilizing data from the Geriatric Head Trauma Short Term Outcomes Project (GREAT STOP), which tracked a cohort of patients aged 65 and older who sustained blunt head trauma from falls at two major trauma centers, the study involved over 3,000 participants. Researchers found that 433 (13.5%) suffered intracranial haemorrhage (ICH), with 561 (18.2%) reporting alcohol consumption.
The results revealed a troubling link between alcohol use and increased risk of ICH. Richard Shih, M.D., the study’s corresponding author and a professor of emergency medicine at FAU, noted that occasional alcohol consumption doubled the odds of ICH compared to non-drinkers. In contrast, daily consumption increased the odds by 150%. The study also demonstrated a clear dose-response relationship between the frequency of alcohol use and the incidence of ICH, with more frequent drinkers facing significantly higher risks.
Demographically, the study observed that alcohol users who suffered head traumas tended to be younger, averaging 78 years, compared to non-users who averaged 83 years. The prevalence of ICH was markedly higher in alcohol users (22%) compared to non-users (12%), and the risk escalated with increasing alcohol consumption. The absolute risk differences associated with alcohol use were substantial, showing a marked increase from occasional to daily drinkers.
Several risk factors for falls have been identified in older adults, including polypharmacy, sudden drops in blood pressure, and unsafe home environments. Shih’s study suggests that alcohol consumption should also be considered a significant, independent, and modifiable risk factor. He explained that alcohol affects balance, concentration, and awareness, thus increasing the likelihood of falls. Additionally, as individuals age, their ability to metabolize alcohol diminishes, compounded by a higher body fat-to-body water ratio, which results in a higher concentration of alcohol in the bloodstream.
Despite these findings, current fall prevention guidelines from entities like the Centers for Disease Control and Prevention’s STEADI initiative of the American Geriatrics Society do not currently address the relationship between alcohol use and falls. Shih advocates for the inclusion of alcohol use assessment and mitigation strategies in fall prevention protocols, stressing the need for comprehensive strategies that consider all significant risk factors to reduce the incidence of falls among older adults effectively.
More information: Alexander Zirulnik et al, Alcohol use is associated with intracranial hemorrhage in older emergency department head trauma patients, Journal of the American College of Emergency Physicians Open. DOI: 10.1002/emp2.13245
Journal information: Journal of the American College of Emergency Physicians Open Provided by Florida Atlantic University
