Aga Ruth, Søgaard Anne Johanne, Holvik Kristin, Hagen Terje P, Idland Gro, Jeyananthan Anita, Melhuus Knut R, Rognerud Marit, Samuelsen Sven Ove, Meyer Haakon E
Institute of Health and Society, University of Oslo, Oslo, Norway.
Department of Physical Health and Aging, Norwegian Institute of Public Health, Oslo, Norway.
Age Ageing. 2025 May 31;54(6). doi: 10.1093/ageing/afaf161.
The high rates of hip fracture in Oslo inspired a new fall prevention pathway based on well-established fall prevention strategies, but specifically focusing on care coordination, osteoporosis treatment and targeting high-risk patients.
To evaluate the effectiveness of the fall prevention pathway.
We performed a controlled before-and-after study in the home-dwelling population aged 65+ years in Oslo, Norway. The intervention consisted of identifying older adults with a fall-related injury, offering them risk assessment and tailored interventions. Using registry data, we compared registered fallers in the two intervention boroughs with the remaining 13 boroughs as controls, with registered fall injuries as time-dependent exposure in Cox regression. Hazard ratios (HRs) for later hip fracture, long-term care and all-cause mortality were estimated, adjusting for the pre-intervention period.
The risk of hip fracture for the Oslo population aged 65+ years declined by 23% from 2012-19. HR for hip fracture amongst registered fallers in the intervention boroughs compared to the controls was 0.95 (95% CI 0.64-1.41). The difference was significant in men only [HR 0.45 (95% CI 0.21-0.95)]. The risk of admittance to long-term care was reduced [HR 0.76 (95% CI 0.62-0.93)]. No significant difference was seen in mortality.
Overall, the risk of later hip fracture was not significantly reduced in all registered fallers in the intervention boroughs, only in men. There was a significant decline in risk of admission to nursing homes in the intervention boroughs. These results suggest that the prevention pathway might have slowed down functional decline in the older Oslo population.
奥斯陆髋部骨折的高发生率促使基于成熟的跌倒预防策略建立了一条新的跌倒预防路径，但特别侧重于护理协调、骨质疏松症治疗以及针对高危患者。
评估跌倒预防路径的有效性。
我们在挪威奥斯陆65岁及以上的居家人群中进行了一项前后对照研究。干预措施包括识别有跌倒相关损伤的老年人，为他们提供风险评估和量身定制的干预措施。利用登记数据，我们将两个干预区登记的跌倒者与其余13个区作为对照进行比较，将登记的跌倒损伤作为Cox回归中随时间变化的暴露因素。估计了后期髋部骨折、长期护理和全因死亡率的风险比（HRs），并对干预前期进行了调整。
2012 - 19年，奥斯陆65岁及以上人群髋部骨折风险下降了23%。与对照组相比，干预区登记跌倒者髋部骨折的HR为0.95（95%CI 0.64 - 1.41）。仅在男性中差异显著[HR 0.45（95%CI 0.21 - 0.95）]。长期护理入院风险降低[HR 0.76（95%CI 0.62 - 0.93）]。在死亡率方面未观察到显著差异。
总体而言，干预区所有登记跌倒者后期髋部骨折风险并未显著降低，仅在男性中降低。干预区养老院入院风险显著下降。这些结果表明，该预防路径可能减缓了奥斯陆老年人群的功能衰退。
