Fall injuries in older adults from an unusual source: Entering and exiting a vehicle

OBJECTIVES: To examine injuries in older adults due to boarding (i.e., entering) and alighting from (i.e., exiting) motor vehicles, with a special emphasis on falls. DESIGN: Retrospective analysis of incident fall injuries while boarding or alighting from a motor vehicle. SETTING: 2001 to 2003 National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) data from a representative sample of 500,000 injury and consumer product-related emergency department (ED) cases in the United States. PARTICIPANTS: Fourteen thousand seven hundred seventy-four persons unintentionally injured while boarding or alighting from a passenger vehicle. MEASUREMENTS: Annualized estimates and injury rates. RESULTS: There were an estimated 37,000 annual boarding and alighting injuries requiring medical care in EDs among older adults, many of these injuries (41.3%) due to falls. Fall rates were higher in women (52.8 per 100,000) than men (29.5 per 100,000) (P<.01). The hospitalization rate was 10 times higher for those aged 65 and older than for those younger than 65 (P<.001). Injury rates differed according to whether the person was boarding or alighting from the vehicle. Fall-related injury associated with alighting was more common (11,030) than with boarding (4,346), and the overall injury rate for alighting (31.0 per 100,000) was more than twice the rate for boarding (12.2 per 100,000). CONCLUSION: The high incidence of falls in older adults in this study points to a variety of injury circumstances that result in falls; therefore, fall prevention activities must address the underlying risks that are widespread in this population.