Fall frequency and characteristics and the risk of hip fractures.

OBJECTIVES

The 2 objectives of this study were to investigate the association between history of falls and risk of hip fracture and to identify characteristics of falls that determine whether or not a hip fracture will occur.

DESIGN

Population-based case-control study.

SETTING

Subjects were selected from the community and from nursing homes in Sydney, Australia.

PATIENTS

There were 412 subjects (205 cases, 207 controls) in the part of the study concerned with falls frequency and risk of hip fracture (age range 65-100 years). Differences between hip fracture-related falls and other falls were studied in 209 cognitively intact subjects: 84 controls who had fallen at least once in the previous 3 years and 125 cases.

MEASUREMENTS

Data were collected with an interviewer-administered questionnaire.

MAIN RESULTS

There was a strong relationship between reported number of falls in the past year and risk of hip fracture. This relationship was stronger among men than among women. There was only 1 statistically significant fall characteristic associated with risk of hip fracture; falling while turning was much more likely to lead to a hip fracture than falling when walking in one direction (age- and sex-adjusted odds ratio: 7.9, 95% confidence interval: 1.4-43.0).

CONCLUSIONS

(1) Taking a simple falls history is a useful way of identifying elderly people, particularly men, at increased risk of hip fracture; (2) The direction of a fall is an important determinant of hip fracture occurrence.