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Monday, 01 October 2018 11:02

The increase in Life Expectancy is a triumph of humanity but also a challenge to modern societies

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With this declaration of intention started the Policy Frame Program about Active Ageing published by the WHO (World Health Organization) in 2002.

In this context, nobody can deny the tremendous growth undertaken by our societies for the last 100 years, which has been accompanied by a significant increase in life expectancy. According to the WHO, the number of people over 60 years age is growing faster than any other population group. While in 2006 this age group was estimated to be 688 million people, it is expected to be almost 2 billion by the end of 2050. By this time, the number of persons belonging to this group will be much larger than that of children under 14 years age (the first time it will happen in the Humankind´s history). In addition, the number of octogenarian, those who require more clinical services and prone to physical impairments, will represent at least 20% of elderly people.

Falls & older adults; the great challenge still unresolved
It is understood that the ageing process is associated to a great number of syndromes and health impairments, which requires a very great deal of professional assistance. Older adults falls, for instance, represent one of the most important problems for healthcare services. Approximately, between 30-35% of persons over 65 years fall at least once a year, reaching 40% those who are over 70 year of age.

It is remarkable the fact that the WHO points out that people who are living in nursing homes fall more often than those who are living in community. Between 30-50% of people who stay long periods institutionalized in care organizations fall every year, and 40% of them, according to figures published by the WHO, are victims of recurrent falls.

In accordance with some surveys carried out by the principal Anglo-Saxon countries (US, Australia and UK), the rate of people who require hospital assistance stemmed from falls injuries range from 1.6 to 3 per 10.000 population. In that sense, it is important to remark that 25% of serious injuries of older adults are consequences of falls, being the trigger event of the 15% of the total medical emergencies visits. Moreover, it is important to say that 50% of hospitalizations of people over 65 years age, closely related to falls, are due to hip fractures, traumatic brain injuries and upper limb injuries.



On the other hand, in many occasions, falls are responsible of the postfall syndrome, which includes frailty, dependency on others, loss of autonomy, immobilization or depression; with an evident restriction in the normal perform of daily life activities.

In terms of economic cost, falls represent a critical issue for the majority of Healthcare services because of their expenses are not stopping to grow year after year. The most important direct costs include drugs and medication, surgery and rehabilitation. On the other hand, indirect costs are mainly related to productivity losses, especially for those people who are still in their active working life.

According to the Global Report on Falls Prevention in Older Age, the cost associated to hospitalization services is the most significant of all, representing near 50% of the total amount. The second highest is the long-term care costs, which can reach 40% of the total amount for Healthcare systems. This report also claims that the average cost of hospitalization due to falls varies between $ 6.700 and $18.000 in the US, being forecasting a total expense of 250 billion by the year 2040 (only in US).

What can innovation do to resolve this challenge?
The significant impact of falls on the National Healthcare Services is forcing Governments to encourage new clinical policies based on prevention and risk management. A good example of that happened in 2007, when the US Senate approved the creation of a specific committee for population screening and fall risk segmentation.

Closely related to these policies, the new healthcare management models plead for the implantation of new strategies focused on risk control, people stratification and segmentation depending on their predisposition to fall. In that way, it will be possible to define better and customized clinical intervention centred on the prevention as a predictor element about the potential evolution of target population. Therefore, the supply of new classification methods of patients, supported by the latest technological advances, will be essential for the correct clinical characterization of patients. 

More often, experts believe ICT tools and other technologies of fall risk evaluation are essential in order to undertake a correct patient’s filiation depending on their risk level. Besides, the application of these new techniques will generate new possibilities in the definition of new clinical protocols and decision-making aid systems, which would allow physicians to improve diagnosis and patients´ future evolution. By means of these protocols, professionals would have the possibility to set up new clinical intervention, earlier and better, fitted to patients´ needs. This is what experts have called Precision Medicine.

Fall risk segmentation tools not only allow professionals, as it has been aforementioned, to prescribe more precise treatments, but they also offer an optimum way to rationalize the overexposed clinical resources (both in specialized and in primary care). Moreover, the measurement of patients´ evolution within the intervention period, lead a more efficient clinical management, especially because it provides objective and reliable data about the effectiveness of medical interventions.

The best is coming…

Doubtlessly, the increase in life expectancy represents a victory for all Humankind, but there are still many challenges to overcome if we want to guarantee a healthy ageing with higher quality of life levels, boosting, at the same time, a more rational use of available clinical resources.

As the saying goes… the challenge is not adding years to life, it is adding life to years. It just depends on us how we want to face it.

David Garrido (Head of Innovation at the IBV)

Further infor at 

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