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The Role of Fall Biomechanics in the Cause and Prevention of Bone Fractures in Older Adults

Current Osteoporosis Reports volume 19, pages 381–390 (2021)Cite this article

Abstract

Purpose of Review

Adults over age 65 experience the highest rates of bone fracture, and 90% of fractures in older adults are caused by falls from standing height or lower. Advances in fracture prevention rely on our ability to prevent falls, reduce the severity of falls, and enhance the resistance of bone to trauma. To help guide these efforts, we need improved understanding on the types of falls that cause fractures.

Recent Findings

In this review, we describe recent evidence on how the mechanics of falls in older adults influence the risk for fractures to the hip, wrist, vertebrae, and humerus. We discuss how fracture risk depends on fall height, fall direction, and landing configuration. We also review the benefits of exercise, wearable protective gear, and environmental modifications in preventing fractures in older adults.

Summary

Our findings highlight promising new directions in fracture prevention, and the need for collaboration between the bone and falls research communities to implement proven strategies and generate new solutions.

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Funding

VK was supported through a Michael Smith Foundation for Health Research Postdoctoral Award (no. 18481), and a Postdoctoral Award in Technology and Aging from the AGE-WELL Network of Centres of Excellence. SNR was supported by grants from the Canadian Institutes of Health Research (AMG-100487, TIR-103945, TEI-138295) and AGE-WELL (AWCRP-2015-WP5.2, AWCRP-2020-04).

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Authors and Affiliations

  1. School of Engineering, The University of British Columbia, Kelowna, BC, Canada

    Vicki Komisar

  2. Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada

    Stephen Neil Robinovitch

  3. School of Engineering Science, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada

    Stephen Neil Robinovitch

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  1. Vicki Komisar
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Contributions

VK and SNR conceptualized the article. VK performed most of the literature search and wrote the first draft. SNR contributed to the literature search, manuscript writing, and critical revisions.

Corresponding author

Correspondence to Stephen Neil Robinovitch.

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Conflict of Interest

SNR has received (1) royalties from Tytex A/X, manufacturer of the Safehip brand of wearable hip protectors; (2) biomechanical consulting fees from Starkey Inc., for the evaluation of hearing aids that incorporate automatic fall detection; and (3) a research grant from SATech Inc., manufacturers of Smartcells compliant flooring systems. VK has received (1) research support from Rheon Labs, on fall detection and injury prevention, and (2) research support from Starkey Inc., for the evaluation of hearing aids that incorporate automatic fall detection.

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All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).

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Observations related to video-captured falls in older adults in long-term care were based on data collected under protocols approved by the Research Ethics Board of Simon Fraser University. Informed consent was provided for sharing of images for research and education. The authors affirm that the human research participants shown in Fig. 1 provided informed consent for publication of these images.

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Komisar, V., Robinovitch, S.N. The Role of Fall Biomechanics in the Cause and Prevention of Bone Fractures in Older Adults. Curr Osteoporos Rep 19, 381–390 (2021). https://doi.org/10.1007/s11914-021-00685-9

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Keywords

  • Falls
  • Bone fracture
  • Injury prevention
  • Older adults
  • Biomechanics