Background Injury, predominantly fall-related injury, is the most common reason for hospitalisation for people with dementia. Trends in fall-related injury hospitalisations for older people generally have changed over the past decade. It is unknown what impact dementia has on these trends.

Methods Fall-related injury hospitalisations during 1 January 2003 to 31 December 2012 for people aged 65 and older admitted to a hospital in New South Wales, Australia were identified. Hospitalisation records were probabilistically linked to provide comprehensive person-based records. Rates were age-standardised to the 2001 Australian Standard population. Trends over time were analysed using negative binomial regression analysis

Results There were 52,502 hospitalisations for people with dementia and 203,330 for people without dementia. People with dementia were more likely to be admitted for a hip fracture (ARR 1.76; 95% CI: 1.73–1.79, p < 0.0001) and traumatic brain injury (TBI) (ARR 1.08; 95% CI: 1.03–1.14, p = 0.0027), but less likely to be admitted for other (non-hip) fractures (ARR 0.72; 95% CI: 0.71–0.73, p < 0.0001) or non-fracture injuries (ARR 0.96; 95% CI: 0.95–0.97, p < 0.001). Hospitalisation rates for people with dementia decreased by 4.2% (95% CI: −5.6−2.7, p < 0.001) per annum for hip fractures and 1.6% (95% CI: 2.3−0.8, p < 0.001) per annum for other fractures, but increased by 7.5% (95% CI: 4.2–10.8%, p < 0.0001) for TBI and 2.0% (95% CI: 0.1–4.0, p = 0.0388) for other non-fracture injuries. In contrast, hip fracture hospitalisation rates remained constant and other fracture and non-fracture injuries increased for people without dementia.

Conclusions Fall-related fracture rates, notably hip fractures, have decreased over the past ten years in people with dementia, whilst there has not been a corresponding decrease in people without dementia. Rates for non-fracture injuries including TBI have increased in both people with and without dementia. The reasons for these differences are not clear.