Citation

Poulstrup A, Jeune B. Eur. J. Public Health 2000; 10(1): 45-50.

Copyright

(Copyright © 2000, Oxford University Press)

DOI

10.1093/eurpub/10.1.45

PMID

unavailable

Abstract

Background: To reduce the number of fall injuries requiring hospital treatment among community-dwelling elderly a community-based intervention programme was set up. The study was designed as a prospective intervention study with the intervention consisting of information and home visits with follow-up, removing physical hazards, treating somatic and psychiatric illnesses and dealing with improper drug consumption, diet insufficiencies and physical and mental inactivity. The setting was five municipalities of the county of Vejle, Denmark (intervention area) with 12,905 community-dwelling elderly (greater than or eq to 65 years) and four other municipalities in the same county (control area) with 11,460 community-dwelling elderly (greater than or eq to 65 years) from 1 January 1986 to 31 March 1988. Method: A separate injury register at hospitals, with catchment areas for the above study population, was established to collect information on fall-related injuries among the community dwelling elderly who were referred to out-patient treatment or hospitalization. The fall injuries requiring treatment were registered for nine months prior to the intervention and for 18 months during the implementation of the intervention programme. Results: The prevented fraction was estimated for all fractures, lower extremity fractures and hip fractures. A non-significant reduction of 14% in the number of all fractures was found in the intervention group compared with the control group. The reduction of lower extremity fractures in the intervention group was found to be significantly greater: 33% (95% CI: 3-63%), due to a highly significant reduction among women: 46% (95% CI: 8-84%), but without reduction 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 last nine months of the intervention period and highest among women living alone. Conclusion: It is possible to reduce the number of major fall-related fractures among elderly with a well-integrated, community-based intervention programme having information, home visits and follow-up as major components and utilizing existing health personnel in a municipality.