Falls and comorbidity: The pathway to fractures

Abstract

The results suggest that the overall reduction in fractures can be explained by reduction in falls related comorbidity.

The incidence of hip fractures in Estonia, 2005–2012

“…Recent studies have suggested that reduction in fractures can be explained by reductions in falls-related comorbidity [45]. Data from Estonia are in line with this hypothesis: over the period of this study, the life expectancy at 65 in Estonian women increased from 18.1 to 20.3 years (2.2 years) [46], indicating an improved general health and prevention and treatment of chronic diseases.…”

The Impact of Disease and Drugs on Hip Fracture Risk

“…We observed positive associations between all disease categories and hip fracture, a pattern reported by others, albeit for a smaller range of diseases, in relation to falls [11] and hip fracture [21]. The threefold increased risk of hip fracture associated with mental and behavioral disorders, the most prevalent of which are disorders caused by psychoactive substances, mood disorders, schizophrenia and dementia, is in accordance with the twofold to threefold increased risk observed in previous cohort studies [14, 21].…”

“…The threefold increased risk of hip fracture associated with mental and behavioral disorders, the most prevalent of which are disorders caused by psychoactive substances, mood disorders, schizophrenia and dementia, is in accordance with the twofold to threefold increased risk observed in previous cohort studies [14, 21]. Dementia and hip fracture share several predisposing and intermediate risk factors, such as advanced age, gait impairments and increased risk of falls [27].…”

“…There is a scarcity of population-based studies reporting the relative or absolute risks of disease and drugs on hip fracture, and such knowledge would provide important information on the public health impact of diseases and their pharmaceutical treatments on hip fracture occurrence [14, 21]. Cohort studies with recruitment based on clinical examination will fail to identify important disease risk factors due to non-inclusion of the frailest elderly.…”

Changes in number and incidence of hip fractures over 12 years in France

“…Nutritional lifestyle changes as calcium and vitamin D supplementation may also contribute to the decrease in hip fracture incidence, especially amongst elderly subjects; however, there is no evidence of an increase of vitamin D intake in Europe [34,35]. Reduction of fall-related comorbidities [36] and prevention of falls may also explain the decrease incidence. Studies showed that the most effective strategies to decrease fall risk in community-living elderly include regular physical training and modification of the fall risk factors: wearing antislip shoes, reducing psychotropic medication and polymedication, vitamin D supplementation, and cataract surgery [37].…”