Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2000 Feb 5;320(7231):341-6.
doi: 10.1136/bmj.320.7231.341.

Quality of life related to fear of falling and hip fracture in older women: a time trade off study

G Salkeld  1 , I D Cameron, R G Cumming, S Easter, J Seymour, S E Kurrle, S Quine
Affiliations
Clinical Trial

Quality of life related to fear of falling and hip fracture in older women: a time trade off study

G Salkeld et al. BMJ. .

Abstract

Objective: To estimate the utility (preference for health) associated with hip fracture and fear of falling among older women.

Design: Quality of life survey with the time trade off technique. The technique derives an estimate of preference for health states by finding the point at which respondents show no preference between a longer but lower quality of life and a shorter time in full health.

Setting: A randomised trial of external hip protectors for older women at risk of hip fracture.

Participants: 194 women aged >/= 75 years enrolled in the randomised controlled trial or who were eligible for the trial but refused completed a quality of life interview face to face.

Outcome measures: Respondents were asked to rate their own health by using the Euroqol instrument and then rate three health states (fear of falling, a "good" hip fracture, and a "bad" hip fracture) by using time trade off technique.

Results: On an interval scale between 0 (death) and 1 (full health), a "bad" hip fracture (which results in admission to a nursing home) was valued at 0.05; a "good" hip fracture (maintaining independent living in the community) 0.31, and fear of falling 0.67. Of women surveyed, 80% would rather be dead (utility=0) than experience the loss of independence and quality of life that results from a bad hip fracture and subsequent admission to a nursing home. The differences in mean utility weights between the trial groups and the refusers were not significant. A test-retest study on 36 women found that the results were reliable with correlation coefficients within classes ranging from 0.61 to 0.88.

Conclusions: Among older women who have exceeded average life expectancy, quality of life is profoundly threatened by falls and hip fractures. Older women place a very high marginal value on their health. Any loss of ability to live independently in the community has a considerable detrimental effect on their quality of life.

PubMed Disclaimer

Comment in

References

    1. Kannus P, Niemi S, Palvanen M, Parkkari J. Fall-induced injuries among elderly people. Lancet. 1997;350:1174. - PubMed
    1. Kannus P. Preventing osteoporosis, falls, and fractures among elderly people. BMJ. 1999;318:205–206. - PMC - PubMed
    1. Melton LJ. Epidemiology of hip fractures: implications. Bone. 1996;18:121–15S. - PubMed
    1. Cumming RG, Nevitt MC, Cummings SR. Epidemiology of hip fractures. Epidemiol Rev. 1997;19:244–257. - PubMed
    1. Jacobsen SJ, Goldberg J, Miles TP, Brody JA, Stiers W, Rimm AA. Race and sex differences in mortality following fracture of the hip. Am J Public Health. 1992;82:1147–1150. - PMC - PubMed

Publication types