Fall frequency and characteristics and the risk of hip fractures

Abstract

Objectives: The 2 objectives of this study were to investigate the association between history of falls and risk of hip fracture and to identify characteristics of falls that determine whether or not a hip fracture will occur.

Design: Population-based case-control study.

Setting: Subjects were selected from the community and from nursing homes in Sydney, Australia.

Patients: There were 412 subjects (205 cases, 207 controls) in the part of the study concerned with falls frequency and risk of hip fracture (age range 65-100 years). Differences between hip fracture-related falls and other falls were studied in 209 cognitively intact subjects: 84 controls who had fallen at least once in the previous 3 years and 125 cases.

Measurements: Data were collected with an interviewer-administered questionnaire.

Main results: There was a strong relationship between reported number of falls in the past year and risk of hip fracture. This relationship was stronger among men than among women. There was only 1 statistically significant fall characteristic associated with risk of hip fracture; falling while turning was much more likely to lead to a hip fracture than falling when walking in one direction (age- and sex-adjusted odds ratio: 7.9, 95% confidence interval: 1.4-43.0).

Conclusions: (1) Taking a simple falls history is a useful way of identifying elderly people, particularly men, at increased risk of hip fracture; (2) The direction of a fall is an important determinant of hip fracture occurrence.