Characteristics of fallers who later sustain a hip fracture: a NOREPOS study

Abstract

Fall prevention programs have shown inconclusive results concerning hip fracture reduction. We found that fallers with poor health, low societal participation, and use of psychotropics/painkillers had a threefold to fivefold increased hip fracture risk compared to non-fallers without these risk factors. This may help target fall prevention towards high-risk individuals. Introduction To investigate whether self-reported information on health, societal participation, and drug use in older people, easily obtainable by health care providers, contribute to predict future hip fracture beyond self-reported falls. Methods We used data from 3801 women and 6439 men aged 70-79 years participating in population-based studies in five counties in Norway 2000-2003. Height and weight were measured. Socioeconomic status, lifestyle, health status, and history of falling were self-reported through questionnaires. Falls last year were dichotomized into one or more versus no falls. Hip fractures were identified by linkage to hospital data with follow-up through 2013. Hazard ratios (HR) with 95% confidence intervals (95% CI) for hip fracture by combinations of risk factors with history of falling were estimated using Cox proportional hazards regression. Results More women (32.4%) than men (27.7%) reported one or more falls during the previous year, and 17.9% of women (n = 682) and 8.9% of men (n = 572) suffered a hip fracture during median 11.6 years of follow-up. Poor health, low societal participation, and use of psychotropics/analgesics among fallers were strong predictors of hip fracture. The presence of all three risk factors and history of falling was associated with HR 2.92 (95% CI 2.10-4.05) for hip fracture in women and HR 4.60 (95% CI 2.71-7.81) in men compared to non-fallers without these factors. Conclusion Our study indicates that self-assessment of health, information about activities outside home, and drug use among fallers far better identify high risk of hip fracture in older people than information about falls alone.

Exploring Factors Associated With Resilience and Physical Activity in Older Men and Women Post-Hip Fracture

“…The findings from this study support prior research suggesting gender differences such that men post-hip fracture had more comorbidities, were more cognitively impaired, were less socially interactive, and spent less time in overall physical activity than women (Søgaard et al, 2022). In addition, model comparisons between genders supported evidence of differences between men and women.…”

The association of FRAX with predictors of falls in the assessment of postmenopausal osteoporosis in Turkey: the fracture study of Turkey (FRACT study)

“…However, the existing literature does not clearly indicate whether weight loss is the key to improving balance in fall intervention programs. While one study found no significant difference in BMI between fallers and non-fallers [ 34 ], another study linked obesity to balance disturbances [ 35 ]. Our study population was clinically overweight, with a mean BMI of 27.6.…”