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. 2005 Apr;11(2):115–119. doi: 10.1136/ip.2004.005835

Gender differences for non-fatal unintentional fall related injuries among older adults

J Stevens 1, E Sogolow 1
PMCID: PMC1730193  PMID: 15805442

Abstract

Objectives: To quantify gender differences for non-fatal unintentional fall related injuries among US adults age 65 years and older treated in hospital emergency departments (EDs).

Methods: The authors analyzed data from a nationally representative sample of ED visits for January 2001 through December 2001, available through the National Electronic Injury Surveillance System All Injury Program (NEISS-AIP). For each initial ED visit, coders record one principal diagnosis (usually the most severe) and one primary part of the body affected.

Results: Based on 22 560 cases, an estimated 1.64 million older adults were treated in EDs for unintentional fall injuries. Of these, approximately 1.16 million, or 70.5%, were women. Fractures, contusions/abrasions, and lacerations accounted for more than three quarters of all injuries. Rates for injury diagnoses were generally higher among women, most notably for fractures which were 2.2 times higher than for men. For all parts of the body, women's injury rates exceeded those of men. Rate ratios were greatest for injuries of the leg/foot (2.3), arm/hand (2.0), and lower trunk (2.0). The hospitalization rate for women was 1.8 times that for men.

Conclusions: Among older adults, non-fatal fall related injuries disproportionately affected women. Much is known about effective fall prevention strategies. We need to refine, promote, and implement these interventions. Additional research is needed to tailor interventions for different populations and to determine gender differences in the underlying causes and/or circumstances of falls. This information is vital for developing and implementing targeted fall prevention strategies.

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Selected References

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  1. Aharonoff G. B., Dennis M. G., Elshinawy A., Zuckerman J. D., Koval K. J. Circumstances of falls causing hip fractures in the elderly. Clin Orthop Relat Res. 1998 Mar;(348):10–14. [PubMed] [Google Scholar]
  2. Alexander B. H., Rivara F. P., Wolf M. E. The cost and frequency of hospitalization for fall-related injuries in older adults. Am J Public Health. 1992 Jul;82(7):1020–1023. doi: 10.2105/ajph.82.7.1020. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Birge S. J. Osteoporosis and hip fracture. Clin Geriatr Med. 1993 Feb;9(1):69–86. [PubMed] [Google Scholar]
  4. Campbell A. J., Spears G. F., Borrie M. J. Examination by logistic regression modelling of the variables which increase the relative risk of elderly women falling compared to elderly men. J Clin Epidemiol. 1990;43(12):1415–1420. doi: 10.1016/0895-4356(90)90110-b. [DOI] [PubMed] [Google Scholar]
  5. Davis M. A., Neuhaus J. M., Moritz D. J., Lein D., Barclay J. D., Murphy S. P. Health behaviors and survival among middle-aged and older men and women in the NHANES I Epidemiologic Follow-up Study. Prev Med. 1994 May;23(3):369–376. doi: 10.1006/pmed.1994.1051. [DOI] [PubMed] [Google Scholar]
  6. Ellis A. A., Trent R. B. Do the risks and consequences of hospitalized fall injuries among older adults in California vary by type of fall? J Gerontol A Biol Sci Med Sci. 2001 Nov;56(11):M686–M692. doi: 10.1093/gerona/56.11.m686. [DOI] [PubMed] [Google Scholar]
  7. Englander F., Hodson T. J., Terregrossa R. A. Economic dimensions of slip and fall injuries. J Forensic Sci. 1996 Sep;41(5):733–746. [PubMed] [Google Scholar]
  8. Greenspan S. L., Myers E. R., Maitland L. A., Resnick N. M., Hayes W. C. Fall severity and bone mineral density as risk factors for hip fracture in ambulatory elderly. JAMA. 1994 Jan 12;271(2):128–133. [PubMed] [Google Scholar]
  9. Griffin M. R., Ray W. A., Fought R. L., Melton L. J., 3rd Black-white differences in fracture rates. Am J Epidemiol. 1992 Dec 1;136(11):1378–1385. doi: 10.1093/oxfordjournals.aje.a116450. [DOI] [PubMed] [Google Scholar]
  10. Hall S. E., Williams J. A., Senior J. A., Goldswain P. R., Criddle R. A. Hip fracture outcomes: quality of life and functional status in older adults living in the community. Aust N Z J Med. 2000 Jun;30(3):327–332. doi: 10.1111/j.1445-5994.2000.tb00833.x. [DOI] [PubMed] [Google Scholar]
  11. Hausdorff J. M., Rios D. A., Edelberg H. K. Gait variability and fall risk in community-living older adults: a 1-year prospective study. Arch Phys Med Rehabil. 2001 Aug;82(8):1050–1056. doi: 10.1053/apmr.2001.24893. [DOI] [PubMed] [Google Scholar]
  12. Hornbrook M. C., Stevens V. J., Wingfield D. J., Hollis J. F., Greenlick M. R., Ory M. G. Preventing falls among community-dwelling older persons: results from a randomized trial. Gerontologist. 1994 Feb;34(1):16–23. doi: 10.1093/geront/34.1.16. [DOI] [PubMed] [Google Scholar]
  13. Jager T. E., Weiss H. B., Coben J. H., Pepe P. E. Traumatic brain injuries evaluated in U.S. emergency departments, 1992-1994. Acad Emerg Med. 2000 Feb;7(2):134–140. doi: 10.1111/j.1553-2712.2000.tb00515.x. [DOI] [PubMed] [Google Scholar]
  14. Kannus P., Parkkari J., Koskinen S., Niemi S., Palvanen M., Järvinen M., Vuori I. Fall-induced injuries and deaths among older adults. JAMA. 1999 May 26;281(20):1895–1899. doi: 10.1001/jama.281.20.1895. [DOI] [PubMed] [Google Scholar]
  15. Melton L. J., 3rd, Chrischilles E. A., Cooper C., Lane A. W., Riggs B. L. Perspective. How many women have osteoporosis? J Bone Miner Res. 1992 Sep;7(9):1005–1010. doi: 10.1002/jbmr.5650070902. [DOI] [PubMed] [Google Scholar]
  16. Nevitt M. C., Cummings S. R., Hudes E. S. Risk factors for injurious falls: a prospective study. J Gerontol. 1991 Sep;46(5):M164–M170. doi: 10.1093/geronj/46.5.m164. [DOI] [PubMed] [Google Scholar]
  17. Oman D., Reed D., Ferrara A. Do elderly women have more physical disability than men do? Am J Epidemiol. 1999 Oct 15;150(8):834–842. doi: 10.1093/oxfordjournals.aje.a010088. [DOI] [PubMed] [Google Scholar]
  18. Parkkari J., Kannus P., Palvanen M., Natri A., Vainio J., Aho H., Vuori I., Järvinen M. Majority of hip fractures occur as a result of a fall and impact on the greater trochanter of the femur: a prospective controlled hip fracture study with 206 consecutive patients. Calcif Tissue Int. 1999 Sep;65(3):183–187. doi: 10.1007/s002239900679. [DOI] [PubMed] [Google Scholar]
  19. Peel N. M., Kassulke D. J., McClure R. J. Population based study of hospitalised fall related injuries in older people. Inj Prev. 2002 Dec;8(4):280–283. doi: 10.1136/ip.8.4.280. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Riggs B. L., Wahner H. W., Dunn W. L., Mazess R. B., Offord K. P., Melton L. J., 3rd Differential changes in bone mineral density of the appendicular and axial skeleton with aging: relationship to spinal osteoporosis. J Clin Invest. 1981 Feb;67(2):328–335. doi: 10.1172/JCI110039. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Robinovitch S. N., Hayes W. C., McMahon T. A. Energy-shunting hip padding system attenuates femoral impact force in a simulated fall. J Biomech Eng. 1995 Nov;117(4):409–413. doi: 10.1115/1.2794200. [DOI] [PubMed] [Google Scholar]
  22. Sterling D. A., O'Connor J. A., Bonadies J. Geriatric falls: injury severity is high and disproportionate to mechanism. J Trauma. 2001 Jan;50(1):116–119. doi: 10.1097/00005373-200101000-00021. [DOI] [PubMed] [Google Scholar]
  23. Tinetti M. E., Williams C. S. Falls, injuries due to falls, and the risk of admission to a nursing home. N Engl J Med. 1997 Oct 30;337(18):1279–1284. doi: 10.1056/NEJM199710303371806. [DOI] [PubMed] [Google Scholar]
  24. Wolinsky F. D., Fitzgerald J. F., Stump T. E. The effect of hip fracture on mortality, hospitalization, and functional status: a prospective study. Am J Public Health. 1997 Mar;87(3):398–403. doi: 10.2105/ajph.87.3.398. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Ytterstad B. The Harstad injury prevention study: the characteristics and distribution of fractures amongst elders--an eight year study. Int J Circumpolar Health. 1999 Apr;58(2):84–95. [PubMed] [Google Scholar]

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