Patterns in health-related behaviours and fall injuries among older people: a population-based study in Stockholm County, Sweden

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Aim: we identified clusters of older people with similar health-related behaviours and assessed the association between those clusters and the risk of injurious fall.

Methods: we linked self-reported and register-based data on the over-65s from the Stockholm public health cohort ( N = 20,212). Groups of people with similar health-related behaviours were identified by cluster analysis using four measures of physical activity, two of smoking and alcohol habits and two individual attributes (age and type of housing). The association between clusters and falls leading to hospitalisation (422 cases) was studied using a nested case–control design. Odds ratios (ORs), crude and adjusted for health status, were compiled by cluster using the one with the most ‘protective’ health behaviour profile as the reference.

Results: five clusters were identified revealing a variety of combinations of health-related behaviours, all linked to specific age groups and types of housing and with a tendency towards higher levels of physical activity among the younger ones. The risk of injurious falls differed across clusters, and for three out of four, it was significantly higher than in the comparison cluster. Adjusting for health status only partially reduced the ORs for those clusters and this was observed both in men and women.

Conclusion: health-related behaviours aggregate in different manners among older people. Some health-related profiles are associated with an excess risk of falls leading to hospitalisation. Although this is partly a reflection of age differences across clusters, health status alone cannot fully explain the association.

Related collections

Most cited references 16

Record: found
Abstract: found
Article: not found

Preventing injuries in older people by preventing falls: a meta-analysis of individual-level data.

M. Robertson, A John Campbell, Melinda Gardner … (2002)

Our falls prevention research group has conducted four controlled trials of a home exercise program to prevent falls in older people. The objectives of this meta-analysis of these trials were to estimate the overall effect of the exercise program on the numbers of falls and fall-related injuries and to identify subgroups that would benefit most from the program. We pooled individual-level data from the four trials to investigate the effect of the program in those aged 80 and older, in those with a previous fall, and in men and women. Nine cities and towns in New Zealand. One thousand sixteen community dwelling women and men aged 65 to 97. A program of muscle strengthening and balance retraining exercises designed specifically to prevent falls and individually prescribed and delivered at home by trained health professionals. Main outcomes were number of falls and number of injuries resulting from falls during the trials. The overall effect of the program was to reduce the number of falls and the number of fall-related injuries by 35% (incidence rate ratio (IRR) = 0.65, 95% confidence interval (CI) = 0.57-0.75; and, respectively IRR = 0.65, 95% CI = 0.53-0.81.) In injury prevention, participants aged 80 and older benefited significantly more from the program than those aged 65 to 79. The program was equally effective in reducing fall rates in those with and without a previous fall, but participants reporting a fall in the previous year had a higher fall rate (IRR = 2.34, 95% CI = 1.64-3.34). The program was equally effective in men and women. This exercise program was most effective in reducing fall-related injuries in those aged 80 and older and resulted in a higher absolute reduction in injurious falls when offered to those with a history of a previous fall.

0 comments Cited 117 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Physical activity, falls, and fractures among older adults: a review of the epidemiologic evidence.

Edward Gregg, Mark A. Pereira, Carl Caspersen (2000)

Assess the relationship between physical activity and risk for falls and osteoporotic fractures among older adults. Review and synthesis of published literature. We searched the literature using MEDLINE, Current Contents, and the bibliographies of articles identified. We included randomized controlled trials (RCT) of the effects of physical activity on the incidence of falls and case-control and prospective cohort studies of the association of physical activity with osteoporotic fracture risk. We also summarized mechanisms whereby physical activity may influence risk for falls and fractures. Observational epidemiologic studies and randomized clinical trials evaluating the effectiveness of physical activity programs to prevent falls have been inconclusive. However, many studies have lacked adequate statistical power, and recent trials suggest that exercise, particularly involving balance and lower extremity strength training, may reduce risk of falling. There is consistent evidence from prospective and case-control studies that physical activity is associated with a 20-40% reduced risk of hip fracture relative to sedentary individuals. The few studies that have examined the association between physical activity and risk of other common osteoporotic fractures, such as vertebral and wrist fractures, have not found physical activity to be protective. Epidemiologic studies suggest that higher levels of leisure time physical activity prevent hip fractures and RCTs suggest certain exercise programs may reduce risk of falls. Future research needs to evaluate the types and quantity of physical activity needed for optimal protection from falls and identify which populations will benefit most from exercise.

0 comments Cited 90 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

A meta-analysis of cigarette smoking, bone mineral density and risk of hip fracture: recognition of a major effect.

Catherine M Law, A K Hackshaw (1997)

To determine the magnitude and importance of the relation between smoking, bone mineral density, and risk of hip fracture according to age. Meta-analysis of 29 published cross sectional studies reporting the difference in bone density in 2156 smokers and 9705 non-smokers according to age, and of 19 cohort and case-control studies recording 3889 hip fractures reporting risk in smokers relative to non-smokers. In premenopausal women bone density was similar in smokers and non-smokers. Postmenopausal bone loss was greater in current smokers than non-smokers, bone density diminishing by about an additional 2% for every 10 year increase in age, with a difference of 6% at age 80. In current smokers relative to non-smokers the risk of hip fracture was similar at age 50 but greater thereafter by an estimated 17% at age 60, 41% at 70, 71% at 80, and 108% at 90. These estimates of relative risk by age, derived directly from a regression analysis of the studies of smoking and hip fracture, were close to estimates using the difference in bone density between smokers and non-smokers and the association between bone density and risk of hip fracture. The estimated cumulative risk of hip fracture in women in England was 19% in smokers and 12% in non-smokers to age 85; 37% and 22% to age 90. Among all women, one hip fracture in eight is attributable to smoking. Limited data in men suggest a similar proportionate effect of smoking as in women. The association was not explained by smokers being thinner, younger at menopause, and exercising less nor by actions of smoking on oestrogen, but smoking may have a direct action on bone. Hip fracture in old age is a major adverse effect of smoking after the menopause. The cumulative excess bone loss over decades is substantial, increasing the lifetime risk of hip fracture by about half.

0 comments Cited 89 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): Age Ageing

Journal ID (iso-abbrev): Age Ageing

Journal ID (publisher-id): ageing

Journal ID (hwp): ageing

Title: Age and Ageing

Publisher: Oxford University Press

ISSN (Print): 0002-0729

ISSN (Electronic): 1468-2834

Publication date (Print): July 2015

Publication date (Electronic): 22 April 2015

Publication date PMC-release: 22 April 2015

Volume: 44

Issue: 4

Pages: 604-610

Affiliations

[1 ]Department of Public Health Sciences, Division of Public Health Epidemiology, Karolinska Institutet , Stockholm, Sverige, Sweden

[2 ]Department of Public Health Sciences, Division of Global Health/IHCAR, Karolinska Institutet , Stockholm, Sweden

Author notes

Address correspondence to: B. Helgadottir. Tel: (+46) 736271296, Email: bjorg.helgadottir@ 123456ki.se

Article

Publisher ID: afv051

DOI: 10.1093/ageing/afv051

PMC ID: 4476848

PubMed ID: 25904445

SO-VID: c9d92d82-85ba-44fb-a06e-044b27b22ec8

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

Patterns in health-related behaviours and fall injuries among older people: a population-based study in Stockholm County, Sweden

Read this article at

Abstract

Related collections

Karger: Digital Health

Most cited references 16

Preventing injuries in older people by preventing falls: a meta-analysis of individual-level data.

Physical activity, falls, and fractures among older adults: a review of the epidemiologic evidence.

A meta-analysis of cigarette smoking, bone mineral density and risk of hip fracture: recognition of a major effect.

Author and article information

Journal

Affiliations

Author notes

Article

History

Categories

Comments

Comment on this article

Similar content 114

Cited by 3

Most referenced authors 357