Association between falling direction and age in older patients with hip fractures
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Gerontologie+Geriatrie Original Contributions Z Gerontol Geriat https://doi.org/10.1007/s00391-020-01824-0 Received: 21 August 2020 Accepted: 2 November 2020 © Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2020
Masanori Morikawa1 · Yukio Urabe1 · Noriaki Maeda1 · Yuta Suzuki1,2 · Sasadai Junpei1 · Toshiki Kobayashi3 · Taizan Shirakawa4 1
Division of Sports Rehabilitation, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan 2 Department of Rehabilitation of Matterhorn Rehabilitation Hospital, Hiroshima, Japan 3 Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China 4 Department of Orthopedics, Matterhorn Rehabilitation Hospital, Hiroshima, Japan
Association between falling direction and age in older patients with hip fractures The incidence of hip fractures has rapidly increased in old people aged over 85 years. In addition, impact of hip fractures in patients aged over 85 years was higher than in those between 65 and 84 years. Some studies revealed that a specific falling direction was associated with greater occurrence of hip fracture, particularly sideways falling; however, these studies did not consider the effect of age. It was expected that the number of hip fractures caused by nonsideways falling would increase in patients aged over 85 years because the ability of postural control in the anterior-posterior direction would deteriorate with age and hip fractures are not only caused by a sideways fall but also by a forward or backward fall
Background and objective Age-related diseases for a population over 85 years are problematic issues [1]. In 2018, the global number of old people over 85 years increased faster than those between 65 and 84 years [2]. In Japan, the National Institute of Population and Social Security Research estimated that the population over 85 years would increase approximately twofold by 2040 compared to 2015 but almost no change in the population between 65 and 84 years [3]. Ag-
ing itself can lead to disease, thus there is a greater need for understanding the impact of aging, especially in populations over 85 years old. Hip fractures are regarded as a worldwide public health concern in the aged and mostly occur by falling. In particular, the incidence of hip fractures has rapidly increased in old people aged over 85 years [4]. A prospective observational cohort study revealed that the impact of hip fractures inpatients aged over85 years was higher than in those between 65 and 84 years [5]. This is due to a higher mortality rate, higher comorbidity incidence, greater cognitive impairment, longer inpatient hospital stay and lower chances of being discharged to the preinjury residence. Several epidemiological studies have revealed that a specific falling direction was associated with greater occurrence of hip fractures, particularly sideways falling [6–8]. Furthermore, Schwartz et al. [6] and Hwang et al. [8] conducted multivariable analyses and demonstrated that sideways falling
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