International and ethnic variability of falls in older men.

AIMS: Fallers and especially recurrent fallers are at high risk for injuries. The aim of this study was to evaluate fall epidemiology in older men with special attention to the influence of age, ethnicity and country of residence. METHODS: 10,998 men aged 65 years or above recruited in Hong Kong, the United States (US) and Sweden were evaluated in a cross-sectional retrospective study design. Self-reported falls and fractures for the preceding 12 months were registered through questionnaires. Group comparisons were done by chi-square test or logistic regression. RESULTS: The proportion of fallers among the total population was 16.5% in ages 65-69, 24.8% in ages 80-84 and 43.2% in ages above 90 (P <0.001). The corresponding proportions of recurrent fallers in the same age groups were 6.3%, 10.1% and 18.2%, respectively (P <0.001), and fallers with fractures 1.0%, 2.3% and 9.1%, respectively (P <0.001). The proportion of fallers was highest in the US, intermediate in Sweden and lowest in Hong Kong (in most age groups P <0.05). The proportion of fallers among white men in the US was higher than in white men in Sweden (all comparable age groups P <0.01) but there were no differences in the proportion of fallers in US men with different ethnicity. CONCLUSIONS: The proportion of fallers in older men is different in different countries, and data in this study corroborate with the view that society of residence influences fall prevalence more than ethnicity.

Prevention of falls in the elderly: a review.

AIMS: Falls often result in soft tissue injuries, dislocations, fractures, longstanding pain and reduced quality of life. Therefore, fall preventive programmes have been developed. METHODS: In this review, we evaluate programmes that in randomized controlled trials (RCT) have been shown with fall reducing effect. RESULTS: Physical exercise that includes several training modalities, especially balance and strength training, is the only intervention programme that reduces both the number of fallers and the number of falls in community dwellers. Home hazards modification reduces the fall risk in community-living elderly but has the best effects in high risk groups when the programme is led by occupational therapists. Vitamin D supplement in those with low levels of vitamin D, adjustment of psychotropic medication and modification of multi-pharmacy are drug-related programmes that reduce the fall risk. Anti-slip shoe devices in elderly who walk outdoors during icy conditions and multifaceted podiatry to patients with specific foot disability are interventions targeted at the lower extremities with a fall-reducing effect. First eye cataract surgery and pacemakers in patients with cardio-inhibitory carotid sinus hypersensitivity are surgical procedures with fall-reducing effect. Multifactorial standardized preventive programmes that include an exercise component and individually-designed subject-specific programmes also reduce the number of falls. CONCLUSIONS: Fall preventive interventions should be provided to elderly by a structured approach, especially to high risk groups, as to reduce the number of falls and fallers.