Prevention of fall injuries requiring hospital treatment among community-dwelling elderly

Background: To reduce the number of fall injuries requiringhospital treatment among community-dwelling elderly a community-basedintervention programme was set up. The study was designed asa prospective intervention study with the intervention consistingof information and home visits with follow-up, removing physicalhazards, treating somatic and psychiatric illnesses and dealingwith improper drug consumption, diet insufficiencies and physicaland mental inactivity. The setting was five municipalities ofthe county of Vejle, Denmark (intervention area) with 12,905community-dwelling elderly (65 years) and four other municipalitiesin the same county (control area) with 11,460 community-dwellingelderly (65 years) from 1 January 1986 to 31 March 1988. Method:A separate injury register at hospitals, with catchment areasfor the above study population, was established to collect informationon fall-related injuries among the community dwelling elderlywho were referred to out-patient treatment or hospitalization.The fall injuries requiring treatment were registered for ninemonths prior to the intervention and for 18 months during theimplementation of the intervention programme. Results: The preventedfraction was estimated for all fractures, lower extremity fracturesand hip fractures. A non-significant reduction of 14% in thenumber of all fractures was found in the intervention groupcompared with the control group. The reduction of lower extremityfractures in the intervention group was found to be significantlygreater: 33% (95% CI: 3–63%), due to a highly significantreduction among women: 46% (95% CI: 8–84%), but withoutreduction among men. Similarly a high, although non-significant,reduction of hip fractures among women was found: 43% (95% CI:-2 - 88%). The reductions appeared to be highest in the lastnine months of the intervention period and highest among womenliving alone. Conclusion: It is possible to reduce the numberof major fall-related fractures among elderly with a well-integrated,community-based intervention programme having information, homevisits and follow-up as major components and utilizing existinghealth personnel in a municipality.