PREVENTING FEMORAL FRACTURES AMONG ELDERLY - THE COMMUNITY SAFETY APPROACH

The current picture of fatal injuries in Sweden is dominated by falls, which account for about 40%. Furthermore, falls are by far the most d ominating cause of hospital in-patient care (57%). The aetiologic mech anisms behind falls and fractures are complicated, with a multifactori al causal pattern. The Lidkoping Accident Prevention Programme - one o f the few comprehensive community intervention programs in the world - provides an opportunity to discuss links between a multifactorial int ervention program and related injuries in the elderly. The incidence o f femoral fractures in Lidkoping shows a significantly declining trend for females (-6.6% per year) and a -5.4% decline for males during the study period of 1987-1992. The control area of Skaraborg County showe d a minor decrease and Sweden as a whole showed an increasing trend du ring the same period. In spite of the methodological problems of attri buting effects in quasi-experiments, there is some support for the cla im that the declining trend in the trial area was largely the result o f the intervention program. This conclusion is further strengthened by the recently published report from the USA showing that a multiple-ri sk-factor intervention strategy resulted in a significant reduction in the risk of falling among elderly persons in the community.