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Older people with frailty may need specific consideration when preparing for future pandemics, according to a new analysis from the Office of National Statistics (ONS) that looked at the number of fractures and falls during national lockdowns.
The analysis found that the number of falls resulting in hospital visits decreased during the national lockdowns, but increased above the modelled expected number when lockdown measures were lifted.
Yet, the number of frail fall and fracture episodes consistently exceeded expected levels throughout the observation period, with the exception of February 2021. Levels peaked in May 2020 during the first national lockdown, and immediately following the second and third national lockdowns.
The post-lockdown increase in the number of falls episodes was only temporary for patients without frailty. However, for frail patients this increase continued, suggesting people with frailty may need specific consideration when preparing for future pandemics.
This could indicate an increase in vulnerability of frail individuals to falls and fractures because of the social isolation, immobility, cognitive decline and physical deconditioning that may have been experienced during these public health interventions.
Fractures much lower than expected during lockdown
In addition, the number of hospital episodes involving fractures were much lower than expected during periods of national lockdown, but returned to expected levels when lockdown measures were lifted.
The analysis also found that the return to expected levels was much slower for pension and older-aged patients than for younger age groups. This suggests a lifestyle change or greater hesitance for older age groups to return to daily activities, or to present themselves at hospital.
The results are from an experimental analysis estimating the impact of coronavirus (Covid-19) on hospital episodes involving falls and fractures during the pandemic period (24 January 2020 to 31 December 2021).
Results from 2020 and 2021 were compared against a modelled estimate of how many falls and fractures would’ve taken place in 2020 and 2021 if the pandemic hadn’t happened. Results were further broken down by age, sex and region.
Decreases in fracture episodes below expected levels were observed between October 2020 and January 2021 in areas where local tiered restrictions were imposed over this period.
It also found that national increases in hospital episodes involving falls came primarily from patients in the South East, the North West, and Yorkshire and The Humber.