Risk Factors for Falls and Fragility Fractures in Community-Dwelling Seniors: A One-Year Prospective Study

Abstract

Objective. To evaluate risk factors for falls and fragility fractures in healthy seniors. Methods. Assessing 50 ambulatory community-dwelling volunteers ≥65 for demographics, BMI, bone mineral density (BMD) (DEXA), fracture risk (FRAX), balance (Biodex), fear of falling (Modified Falls Efficacy Scale (MFES)), and activity level (RAPA). One-year followup was done through phone interviews. Results. Most participants (17 males, 33 females; mean age 72.0±5.5 years) had normal BMD and were active with little to no fear of falling. Balance did not correlate with FRAX or fear of falling. Activity level did not correlate with FRAX, but the active group had less fear of falling. Most scored below age specific norms on balance testing. Fear of falling was not significantly different between genders but did correlate with FRAX, indicating that patients with higher fracture risk were also more afraid of falling. Individuals who fell after one year had increased fear of falling and decreased activity levels. Conclusions. Community-dwelling seniors with higher risk of future fractures were more afraid of falling. Although healthy and active, this cohort had poor balance compared to age matched norms. Further research on how to best assess fall risk and improve balance to prevent fractures is needed.