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Determinants, circumstances and consequences of injurious falls among older women living in the community
  1. Elizabeth A Phelan1,
  2. Eileen Rillamas-Sun2,
  3. Lisa Johnson2,
  4. Michael J LaMonte3,
  5. David M Buchner4,
  6. Andrea Z LaCroix5,
  7. Garnet L Anderson2
  1. 1 Division of Gerontology and Geriatric Medicine and Department of Health Services, University of Washington, Seattle, Washington, USA
  2. 2 Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
  3. 3 Department of Epidemiology and Environmental Health, University at Buffalo - The State University of New York, Buffalo, New York, USA
  4. 4 Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
  5. 5 Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USA
  1. Correspondence to Dr Elizabeth A Phelan, Division of Gerontology and Geriatric Medicine, University of Washington, Seattle, Washington, USA; phelane{at}


Objective To identify the risk factors of women who fell with injury relative to women who did not fall or fell without injury and to describe the circumstances and consequences of injurious and non-injurious falls.

Methods We analysed 5074 older women from the Objective Physical Activity and Cardiovascular Health Study who prospectively tracked their falls using a 13-month calendar. Women with a reported fall were phone interviewed about fall-related details, including injuries. Risk factors were identified from surveys and clinical home visits. Logistic regression models were used to calculate adjusted ORs and 95% CIs for injurious falls relative to not falling or falling without injury. Circumstances of injurious and non-injurious falls were compared.

Results At least one fall was experienced by 1481 (29%) participants. Of these, 1043 were phone interviewed, of whom 430 (41%) reported at least one injurious fall. Relative to not falling, the risk factor most strongly associated with experiencing an injurious fall was having fallen ≥2 times (OR 4.0, CI 2.7 to 5.8) in the past year. Being black was protective for fall-related injury (OR 0.6, CI 0.4 to 0.9). No strong associations in risk factors were observed for injurious relative to non-injurious falls. Injurious falls were more likely to occur away from and outside of the home (p<0.05). Over half of those who injured self-managed their injury.

Conclusion Falling repeatedly is a powerful risk factor for injurious falls. Those who have fallen more than once should be prioritised for interventions to mitigate the risk of an injurious fall.

  • planning
  • fall
  • epidemiology
  • older people

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  • Funding This study was funded by Women’s Health Initiative is supported by the National Heart, Lung and Blood Institute (contracts HHSN268201100046C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, HHSN268201600004C, and HHSN271201600004C). OPACH was supported by NHLBI (grant R01HL105065).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository. OPACH data are publicly available on the Women's Health Initiative website.