Am J Epidemiol 2004; 159:192-203.
Copyright © 2004 by the Johns
Hopkins Bloomberg School of Public Health
ORIGINAL CONTRIBUTIONS |
Characteristics of Fallers Who Fracture at the Foot, Distal Forearm, Proximal Humerus, Pelvis, and Shaft of the Tibia/Fibula Compared with Fallers Who Do Not Fracture
1 Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA.
2 Stanford Center for Research in Disease Prevention, Department of Medicine, Stanford University School of Medicine, Stanford, CA.
3 Division of Research, Kaiser Permanente Medical Care Program, Oakland, CA.
This case-control study examined the relation of circumstances of falls and characteristics of fallers with risk of fractures at five sites among persons 45 years of age or older from five Kaiser Permanente Medical Centers in Northern California from 1996 to 2001. Included were distal forearm (n = 1,016), foot (n = 574), proximal humerus (n = 467), pelvis (n = 150), and shaft of the tibia/fibula (n = 141) cases who fell at the time of their fracture, and controls (n = 512) who reported falling in the year before the interview but did not fracture. Interviewers collected information by using a standardized questionnaire. Medium-/high-heeled shoes and shoes with a narrow heel increased the risk of all fractures, and slip-on shoes (adjusted odds ratio = 2.3, 95% confidence interval: 1.4, 4.0) and sandals (adjusted odds ratio = 3.1, 95% confidence interval: 1.5, 6.3) increased the risk of foot fractures. Falling from more than a standing height increased the risk of all fractures by two- to fivefold, while breaking the fall was associated with lower risks of all fractures except the distal forearm. Physical activity and hormone therapy were associated with lower risks of most fractures. These results suggest ways in which risks of fractures in older persons can be reduced.
accidental falls; aging; biomechanics; foot; forearm; fractures; pelvis; shoes
Abbreviations: Abbreviations: CI, confidence interval; OR, odds ratio.
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