Citation

Chen JS, Sambrook PN, Simpson JM, March LM, Cumming RG, Seibel MJ, Lord SR, Cameron ID. J. Clin. Epidemiol. 2010; 63(6): 679-685.

Affiliation

Institute of Bone and Joint Research, Royal North Shore Hospital, St Leonards, New South Wales 2065, Australia.

Copyright

(Copyright © 2010, Elsevier Publishing)

DOI

10.1016/j.jclinepi.2009.08.018

PMID

19926449

Abstract

OBJECTIVES: The aims of this study were to develop and evaluate a simple index for assessing the risk of fractures after a fall and to propose a selection strategy for identifying elderly individuals at high risk of both falls and fall-related fractures. STUDY DESIGN AND SETTING: Two thousand five institutionalized older men and women were assessed for clinical risk factors and then followed up for falls and fall-related fractures for up to 2 years. RESULTS: Our fracture risk index is derived from seven previously identified significant independent risk factors: weight, lower leg length, balance, cognitive function, type of institution, fracture history, and falls in the past year. The fracture rate was 6.5 times greater in the one-sixth of the falls with the highest index (9.7/100 falls) than in the lowest sixth (1.5/100 falls). Our proposed approach (based on balance, risk of falls, and the fracture risk index) selected a group of older people with high risk of both falls and fall-related fracture. The fracture incidence rate was 144% higher, and the falls incidence rate was 31% higher in the selected residents than in the remainder. CONCLUSION: The index could help rationalize fracture prevention programs for frail older people.

Language: en