Citation

Schene MR, Wyers CE, Driessen AMH, Souverein PC, Gemmeke M, van den Bergh JP, Willems HC. Age Ageing 2023; 52(10): afad201.

Copyright

(Copyright © 2023, Oxford University Press)

DOI

10.1093/ageing/afad201

PMID

37930741

Abstract

RATIONALE: Adults with a recent fracture have a high imminent risk of a subsequent fracture. We hypothesise that, like subsequent fracture risk, fall risk is also highest immediately after a fracture. This study aims to assess if fall risk is time-dependent in subjects with a recent fracture compared to subjects without a fracture.

METHODS: This retrospective matched cohort study used data from the UK Clinical Practice Research Datalink GOLD. All subjects ≥50 years with a fracture between 1993 and 2015 were identified and matched one-to-one to fracture-free controls based on year of birth, sex and practice. The cumulative incidence and relative risk (RR) of a first fall was calculated at various time intervals, with mortality as competing risk. Subsequently, analyses were stratified according to age, sex and type of index fracture.

RESULTS: A total of 624,460 subjects were included; 312,230 subjects with an index fracture, matched to 312,230 fracture-free controls (71% females, mean age 70 ± 12, mean follow-up 6.5 ± 5 years). The RR of falls was highest in the first year after fracture compared to fracture-free controls; males had a 3-fold and females a 2-fold higher risk. This imminent fall risk was present in all age and fracture types and declined over time. A concurrent imminent fracture and mortality risk were confirmed.

CONCLUSION/DISCUSSION: This study demonstrates an imminent fall risk in the first years after a fracture in all age and fracture types. This underlines the need for early fall risk assessment and prevention strategies in 50+ adults with a recent fracture.

Language: en

Keywords

Aged; Humans; Female; Male; Aged, 80 and over; Risk Assessment; Seasons; Cohort Studies; Retrospective Studies; risk; *Fractures, Bone/epidemiology; accidental falls; clinical practice research datalink; imminent fall risk; imminent fracture risk; older people