Falls and Fall-Related Injuries Among the Elderly: A Survey of Residential-Care Facilities in a Swedish Municipality

Injurious falls among the elderly are an increasing public-health problem in Sweden. One group particularly vulnerable to falls consists of elderly people living in residential-care facilities. The purpose of this study was to investigate the extent to which falls lead to injury within a defined population of elderly people in institutionalized care. All the elderly persons living in residential-care facilities in an urban Swedish municipality during the year 1997 (n = 469 institutional places). Falls and fall-related injuries were registered over a one-year period. Data were gathered by personnel at the time of the falls, using a form specifically designed for surveillance purposes. Of the 865 falls reported during the study period, 375 were among men, with an average age of 82 years, and 490 among women, with an average age of 85 years. Men were subject to falling to a greater extent than women. The most common location was the individual's own bedroom. Injuries were incurred in approximately one in four falls, and the head was the body part most frequently injured. Only 24 falls (2.8%) resulted in a fracture, of which 18 were hip fractures. Although elderly people living in residential-care facilities fall fairly often, serious injuries, in the form of fractures, are incurred to a relatively limited extent.

[1]  D Fife,et al.  Northeastern Ohio trauma study: I. Magnitude of the problem. , 1983, American journal of public health.

[2]  M. Tinetti,et al.  Risk factors for falls among elderly persons living in the community. , 1988, The New England journal of medicine.

[3]  L. Svanström Simply osteoporosis — or multifactorial genesis for the increasing incidence of fall injuries in the elderly? The need for a scientific approach to reducing injuries , 1990, Scandinavian journal of social medicine.

[4]  S. Cummings,et al.  Risk factors for injurious falls: a prospective study. , 1991, Journal of gerontology.

[5]  A. Odén,et al.  Accidents in the institutionalized elderly: A risk analysis , 1991, Aging.

[6]  K. Thorngren,et al.  Standing balance in hip fracture patients. 20 middle-aged patients compared with 20 healthy subjects. , 1991, Acta orthopaedica Scandinavica.

[7]  F. Piette,et al.  [Epidemiology of fractures of the proximal femur]. , 1992, Presse medicale.

[8]  P. Jäntti,et al.  Falls among elderly nursing home residents. , 1993, Public health.

[9]  M. M. Petersen,et al.  Effect of external hip protectors on hip fractures , 1993, The Lancet.

[10]  W C Hayes,et al.  Fall severity and bone mineral density as risk factors for hip fracture in ambulatory elderly. , 1994, JAMA.

[11]  S. Cummings,et al.  Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group. , 1995, The New England journal of medicine.

[12]  L. Nyberg,et al.  Falls Leading to Femoral Neck Fractures in Lucid Older People , 1996, Journal of the American Geriatrics Society.

[13]  M Kataja,et al.  Falls among institutionalized elderly--a prospective study in four institutions in Finland. , 1996, Scandinavian journal of caring sciences.

[14]  A Heinonen,et al.  Epidemiology of hip fractures. , 1996, Bone.

[15]  W A Ray,et al.  A randomized trial of a consultation service to reduce falls in nursing homes. , 1997, JAMA.

[16]  N. Zethraeus,et al.  The cost of a hip fracture. Estimates for 1,709 patients in Sweden. , 1997, Acta orthopaedica Scandinavica.

[17]  J. Parkkari Hip fractures in the elderly--epidemiology, injury mechanisms, and prevention with an external hip protector. , 1998, Annales chirurgiae et gynaecologiae.

[18]  K. Michaëlsson,et al.  Socioeconomic Status, Marital Status and Hip Fracture Risk: A Population-Based Case–Control Study , 2000, Osteoporosis International.

[19]  A. Ramnemark,et al.  Stroke, a major and increasing risk factor for femoral neck fracture. , 2000, Stroke.

[20]  R. Cumming,et al.  Visual impairment and risk of hip fracture. , 2000, American journal of epidemiology.

[21]  L. Nyberg,et al.  Predisposing and precipitating factors for falls among older people in residential care. , 2002, Public health.

[22]  Lillemor Lundin-Olsson,et al.  Falls among frail older people in residential care , 2002, Scandinavian journal of public health.

[23]  Claus Christiansen,et al.  Consensus development conference: Prophylaxis and treatment of osteoporosis , 2005, Osteoporosis International.

[24]  J. Kanis,et al.  Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: Synopsis of a WHO report , 1994, Osteoporosis International.