Bone and Fall-Related Fracture Risk

Abstract

In older people the risk of falls and fall-related fractures is an increasing health problem. In the elderly most fragility fractures are caused by falling from a standing or sitting position. A key component to prevent falls is the identification of factors which may be responsible for falls and fall-related consequences. Screening or assessment of fall risk should be integrated into the history and physical examination of all geriatric patients with osteoporosis. In general, evidence suggests that interventions individually tailored to target risk factors and impairments are more effective than those applied as a standard package. Group- and home-based exercise programs and home safety interventions reduce rate of falls and risk of falling in community-dwelling elderlies. In care facilities, mostly vitamin D supplementation is effective in reducing the rate of falls. Evidence for multifactorial interventions in care facilities suggests possible benefits. There is no evidence that assistive devices like canes and walkers reduce the risk of falling or the rate of falls. However, several interventions targeting patients with specific morbidities should be considered in the prevention of falls.