Falls and Fractures: A Podcast with Sarah Berry

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GeriPal - A Geriatrics and Palliative Medicine Podcast 46 min 3 speakers 6 chapters transcribed 9 hours ago
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What is the overall impact of falls on older adults and why should clinicians care?

Eric Widera 0:00
Welcome to the Jerry Powell podcast. This is Eric Huadera. This
Alex Smith 0:03
is Alex Smith. And Alex,
Eric Widera 0:05
who do we have with us today in studio?
Alex Smith 0:08
In studio, visiting professor coming to us from Boston. She is a returning Jerry Powell guest. This is Sarah Berry, who is at the Hebrew Senior Life and Beth Israel Deaconess Medical Center and Harvard Medical School. And she's a practicing geriatrician and researcher. Sarah, welcome back to the Jerry Powell podcast.
Sarah Berry 0:28
Thanks so much. Happy to be here.
Eric Widera 0:30
So we're going to be talking about falls and fractures. We've got a lot to talk about. We've got a lot of questions. But before we do, Sarah, do you have a song request for Alex?
Sarah Berry 0:38
Ooh, how about Free Fallin'?
Eric Widera 0:41
Free Fallin'. I was going to ask why you chose this song.
Alex Smith 0:45
We did this like one of our first podcasts, I remember. And the second verse, I kind of went for it. But today I'm not because it is November 6th and I'm feeling subdued.
Eric Widera 0:57
Subdued. We won't talk about what happened on November 5th.
Alex Smith 1:02
So here's a little bit of subdued free-falling.
Unknown 1:11
She's a good girl Loves her mama Loves Jesus And America too She's a good girl Crazy about Elvis Loves horses And her boyfriend too It's a long day, living in Reseda
Sarah Berry 1:49
There's a
Unknown 1:50
freeway, running through the yard I'm a bad boy, cause I don't even miss her I'm a bad boy, for breaking her heart And I'm free Free falling. Said I'm free. Free falling.
Eric Widera 2:33
Sarah, excellent song.
Sarah Berry 2:35
That was nice.
Eric Widera 2:36
Choice. Is there any other reason you picked that song besides... Are you a Tom Petty fan?
Sarah Berry 2:42
I am a Tom Petty fan. But it was just the first thing that came to mind when you asked me to talk about falls.
Eric Widera 2:49
Well, I want to thank you for joining us because you've done a lot of the studies around falls and fractures and like how we think about it, especially like in frailer, older adults, those in nursing homes. I wonder, how did you get interested in this as like a research academic focus of yours?
Sarah Berry 3:08
Yeah. You know, when I went into my geriatric fellowship or even during residency, I think that I thought that I was going to be interested in dementia and that maybe that would be my line of focus. But I was really struck early on in my training by the number of patients that had these serious falls, fractures, sort of this feeling that they were never going to get back home or they weren't going to get back home in the same shape that they were before. And I had a good mentor in residency that really encouraged me, you know, if you want to think about the problem, think about clinical research and was really fortunate to have great mentorship throughout my career.
Eric Widera 3:49
Great. And when you think about like back then, I guess now too, like how big of a problem is Falls?
Sarah Berry 3:57
Yeah. It's a pretty big problem for older adults. I'd say in community dwellers, about one out of every three older adults falls each year. In the nursing home, that's higher. It's one out of two. Wow. I think the CDC estimates that every 20 minutes, an older adult dies from a fall-related injury. Wow. And many more are injured.
Eric Widera 4:22
Yeah. And the big things that we think about as far as complications, so obviously the thing that comes to everybody's mind is like fractures. But there's other things too, right? Like increased social isolation because there's a fear of falling. Is that right?
Sarah Berry 4:36
Yeah, absolutely. Even the falls that don't result in a major injury like the fracture, the head traumas, even the falls without those tend to result in an increase in fear of falling, anxiety, and institutionalization.
Eric Widera 4:51
Yeah. I wonder how much, because it's probably not brought up a lot in primary care settings. People don't ask about it. They don't screen about it. I'm guessing older adults don't bring it up frequently that they've fallen. So it's a silent, I don't want to say silent epidemic that's used too often, but there's silence around these falls. And there's probably some nihilism about kind of, oh, what can we do about falls anyways? Yeah.
Sarah Berry 5:17
I think all of that is true. I think there's just sort of this feeling that maybe it's inevitable because it happens so often. I think both the patients feel that.

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