Diversity in fall characteristics hampers effective prevention: the precipitants, the environment, the fall and the injury
AuthorSanders, KM; Lim, K; Stuart, AL; Macleod, A; Scott, D; Nicholson, GC; Busija, L
Source TitleOsteoporosis International
PublisherSPRINGER LONDON LTD
AffiliationMedicine, Western Health
Document TypeJournal Article
CitationsSanders, K. M., Lim, K., Stuart, A. L., Macleod, A., Scott, D., Nicholson, G. C. & Busija, L. (2017). Diversity in fall characteristics hampers effective prevention: the precipitants, the environment, the fall and the injury. OSTEOPOROSIS INTERNATIONAL, 28 (10), pp.3005-3015. https://doi.org/10.1007/s00198-017-4145-6.
Access StatusOpen Access
NHMRC Grant codeNHMRC/251682
Falls among the elderly are common and characteristics may differ between injurious and non-injurious falls. Among 887 older Australian women followed for 1.6 years, 32% fell annually. Only 8.5% resulted in fracture and/or hospital admission. The characteristics of those falls are indistinguishable from those not coming to medical attention. INTRODUCTION: The precipitants and environment of all falls occurring among a large cohort of older Caucasian women were categorised by injury status to determine if the characteristics differed between injurious and non-injurious falls. METHODS: Among 887 Australian women (70+ years), falls were ascertained using monthly postcard calendars and a questionnaire was administered for each fall. Hospital admissions and fractures were independently confirmed. RESULTS: All falls were reported for a mean observation time of 577 (IQR 546-607) days per participant, equating to a total 1400 person-years. Thirty-two percent fell at least once per year. The most common features of a fall were that the faller was walking (61%) at home (61%) during the day (88%) and lost balance (32%). Only 12% of all falls occurred at night. Despite no difference in the type of injury between day and night, the likelihood of being hospitalised from a fall at night was 4.5 times greater than that of a daytime fall with adjustment for injury type and participant age (OR 4.5, 95% CI 2.1, 9.5; p < 0.001). Of all falls, approximately one third were associated with no injury to the faller (31%), one third reported a single injury (37%) and one third reported more than one injury (32%). In 95% of falls, the faller was not admitted to hospital. Only 5% of falls resulted in fracture(s). CONCLUSIONS: Our findings demonstrate the significant diversity of precipitants and environment where falls commonly occur among older community-dwelling women. Falls resulting in fracture and/or hospital admission collectively represent 8.5% of all falls and their characteristics are indistinguishable from falls not coming to medical attention and incurring no apparent cost to the health system.
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