R. Norton et al., CIRCUMSTANCES OF FALLS RESULTING IN HIP-FRACTURES AMONG OLDER-PEOPLE, Journal of the American Geriatrics Society, 45(9), 1997, pp. 1108-1112
OBJECTIVES: To describe the circumstances of falls resulting in hip fr
actures among older people and to determine whether the circumstances
differ by gender, age, and residential status. DESIGN: Cross-sectional
study. SETTING: Two hospitals in Auckland, New Zealand, in which all
individuals aged 60 years or older with a fracture of the proximal fem
ur are hospitalized. PARTICIPANTS: A total of 911 individuals (97% res
ponse rate) were hospitalized with fractures of the proximal femur; 77
% were women, 66% were aged 80 years or older, and 58% were living in
private homes at the time of fracture. MEASUREMENTS: Data were collect
ed face-to-face by a trained interviewer using a standardized question
naire. RESULTS: Ninety-six percent of the fractures were associated wi
th a fall, with fewer that 2% of subjects reporting that their fractur
es occurred spontaneously before a fall. Sixteen percent of fractures
were associated with an acute medical or physical condition. Although
85% of the fractures involving a fall occurred at home, only about 25%
of these were associated with an environmental hazard, and only a pro
portion of these were likely to have been amenable to modification. Th
e circumstances of falls differed significantly by age and residential
status. CONCLUSION: Strategies aimed at preventing fall-related hip f
ractures among the old old and among institutionalized individuals sho
uld focus primarily on the modification of intrinsic factors. Modifica
tion of environmental hazards has the greatest potential for preventio
n among the young old and those living in private homes.