INCIDENCE OF INJURY-CAUSING FALLS AMONG OLDER ADULTS BY PLACE OF RESIDENCE - A POPULATION-BASED STUDY

OBJECTIVE: To describe the incidence and associated factors of injury- causing falls by place of residence. DESIGN: A prospective population- based study. SETTING: Five municipalities in northern Finland. PARTICI PANTS: All persons in the five communities aged 70 years or older livi ng at home (n = 1016) and in long-term institutionalized care (n = 143 ). MEASUREMENTS: We recorded all fall incidents during a 2-year period by occurrence and severity of injury, using diary reporting and regul ar calls and by examining the medical and nursing records of all parti cipants. The times, places, circumstances, and medical treatment neede d were recorded as well. RESULTS: Men living at home experienced 71 mi nor injuries/1000 person years (PY), 42 major soft tissue injuries/100 0PY, and 12 fractures/1000PY; women at home experienced 175 minor inju ries/1000PY, 65 major soft tissue injuries/1000PY, and 33 fractures/10 00PY. Institutionalized older men had 272 minor injuries/1000PY, 122 m ajor soft tissue injuries/1000PY, and 41 fractures/1000PY; institution alized women had 292 minor injuries/1000PY, 131 major soft tissue inju ries/1000PY, and 58 fractures/1000PY. Falls causing injury to older ad ults in long-term institutionalized care were more evenly distributed by time of day than those that occurred at home. The majority of the i njuries sustained in long-term institutionalized care were injuries to the head. The incidence rate of fall injuries requiring medical atten tion in women, 113/1000PY, was twice that in men, 57/1000PY. CONCLUSIO NS: Injury-causing falls are more frequent in older people living in l ong-term institutionalized care, and the time-distribution and some ci rcumstances differ from those of injury-causing falls in home-dwelling older people.