STUMP » Articles » The Death of Ivana Trump: Falls are Dangerous for Seniors » 17 July 2022, 16:46

From the Washington Post:

Ivana Trump died of ‘blunt impact injuries,’ medical examiner says
By Adela Suliman and Shayna Jacobs
July 16, 2022 at 5:54 a.m. EDT

Ivana Trump, the first wife of former president Donald Trump, died of “blunt impact injuries” to her torso, according to a report from the New York City chief medical examiner Friday. The manner of death was classified as an accident, the report added.

The Trump family announced that Ivana, 73, mother of Ivanka, Eric and Donald Jr., had died at home in Manhattan on Thursday.

….
Ivana Trump was found unconscious on a staircase in her East 64th Street home near Central Park after police received an emergency call at 12:40 p.m., and she was pronounced dead at the scene, according to two law enforcement officials with knowledge of the event.
….
More than one in four Americans older than 65 fall each year, and falls are the leading cause of injury-related death among that age group, according to the Centers for Disease Control and Prevention. Deaths from falling occur at a rate of about 64 deaths per 100,000 older adults, it said.

While 73 is a relatively young age for Americans to die, the apparent way in which Ivana Trump died is going to be coming more to the fore with the aging of the Boomers (and yes, the former Mrs. Trump was a Baby Boomer, born in 1949.)

I will follow the CDC link, and then provide my own breakout of info.

On falls as the major cause of accidental deaths for seniors

Here is the CDC page of fall deaths:

Falls are the leading cause of injury-related death among adults age 65 and older, and the age-adjusted fall death rate is increasing.1,2 The age-adjusted fall death rate is 64 deaths per 100,000 older adults.1

Fall death rates among adults age 65 and older increased about 30% from 2009 to 2018. The increase was observed in 30 states and the District of Columbia. The fastest growing rate was among adults aged 85 and older (about 4% per year).1

The rising number of deaths from falls among older adults can be addressed by screening for fall risk and intervening to address risk factors such as use of medicines that may increase fall risk, or poor strength and balance.

They link to this STEADI = Stopping Elderly Accidents Deaths and Injuries page which then links to this page on falls. They don’t really make any of this user-friendly, frankly, with most of the resources for professionals like doctors or those who run nursing homes.

The problem is that there are multiple parts of the problem. There is simply becoming more frail, and thus more likely to have a severe injury when you fall and less able to heal from such an injury. This is similar to high motor vehicle accident death rates among the elderly — it’s not that they’re particularly reckless drivers, in terms of high speeds, but that if they get in an accident, they are more likely to die from their injuries compared to someone much younger.

But there is the issue of cognitive and motor function impairments as well, that make falls more likely.

Here is the graph that the CDC provides on this page of fall facts:

I will note that the graph just says fall death rates increased 30% for older adults, but doesn’t tell us if they’re graphing crude death rates for the whole population, age-adjusted death rates, death rates for those over a particular age or what.

So now it’s my turn. I’m going to show you some death rate data for falls, through 2020.

Fall death rate data for 2019 by age group

First, let me show you a snapshot, using a linear and then a logarithmic scale. To avoid any pandemic effects, let’s look at 2019:

Obviously, the risk is much higher at older ages than at younger ages. We can barely see the rates for younger adults on the linear scale.

So, as I often do, in switching to a logarithmic scale, you can see the “natural” age effects — falls, which are an external cause of death, operate similar to physiological causes of death which look linear when you graph them by age and rate by logarithmic scale. Basically, you’re measuring frailty.

That’s a snapshot for 2019. Let’s look at how it’s changed over time.

Fall death rate trends, 1999-2020

So here is the concerning trend: fall death rates have been worsening for older adults. And even worse the older you go.

I can think of multiple explanations, though I’m not researching it myself right now. But notice how steadily these rates are growing. It’s also growing for both age 55-64 years and 65-74 years at 3.4% per year for 1999-2020 on average. So notice that the rate of growth is higher for higher ages.

Here are three explanations I can think of:

1. Older people are more likely to be living alone now, due to smaller families, and more likely to live farther away from family. Therefore, if you fall, you’re less likely to have someone there to help you.
2. One of the few major causes of death that has had a worsening trend for older adults as well is Alzheimer’s disease. Dementia and falls are related.
3. Growing size of houses means older people are more likely to be living in houses with stairs. That’s a big hazard.

Don’t deny the effects of aging

Aging and the frailty that comes with it are real bummers, and it would be nice if we could just wish them away.

I know there are various projects to attempt to “cure” aging in various respects. I don’t mean the sort of literally skin deep cosmetic surgery treatments out there that may fool others (or yourself) into thinking you are more youthful and sturdy. I mean really preventing or even undoing the degenerative systemic effects of what we currently call the condition of “aging”. I think that would be fabulous. I also believe some of the extension of lifetimes, with accompanying healthy lifetimes, which has been linked to reduced smoking and improved environmental conditions (no leaded gasoline, cleaner air and water), is an incremental improvement.

However.

We do still have aging, and yes, we do lose physical and cognitive abilities as we age.

That has effects, and that increases certain sorts of risks. I note in this comment thread at the Althouse blog, many older commenters mention they plain lie to their doctors about their falling.

Y’all, I’m sorry. I think this is a really bad idea. You think — “Oh, it’s normal to fall.” Yes, but as you are getting old, and if you’re over 65 years old, Boomers, yes, you are old, you are becoming frailer, this is getting dangerous.

My grandma took a hint herself in her 70s that when she tripped on a student’s desk and broke her arm, she had become too frail to be in a classroom. She had qualified for retirement years before, but this was the signal she was physically unable to do it anymore. Family members helped to adapt her home with ramps so that she didn’t have to worry about the few steps her house had to raise the house above the swampy land of the area.

There was a second thread about the treacherous staircase in Ivana Trump’s home. And now going down a different tangent, it makes me think of Winston Churchill’s mother Jennie who essentially killed herself with some fancy shoes.

In May 1921, while Montagu Porch [Jennie’s 3rd husband] was away in Africa, Jennie slipped while coming down a friend’s staircase wearing new high-heeled shoes, breaking her ankle. Gangrene set in, and her left leg was amputated above the knee on 10 June. At age 67, she died at her home at 8 Westbourne Street in London on 29 June, following a haemorrhage of an artery in her thigh resulting from the amputation.

And that may have been a similar story for Ivana Trump – she may have been wearing heels, coming down her own staircase, slipped, and hurt herself too badly that at her age it killed her.

Or she could have just been wearing socks.

In any case, be careful, y’all. Falls are very dangerous the older you get.