Incidence and characteristics of falls leading to hospital treatment: a one-year population surveillance study of the Danish population aged 45 years and over.

AIMS: The aim was to quantify and characterize the incidence of fall injury events among middle-aged and older adults who require acute medical attention at Danish hospitals.
METHODS: A one-year population surveillance study was carried out, based on the Danish National Hospital Register (DNHR), which covers all somatic hospital discharges and accident and emergency (A&E) services at hospitals in Denmark.
RESULTS: During 1996 a total of 81,121 fall injury events were treated at A&E departments or resulted in admission to a somatic hospital department among Danes aged 45 years and over. Up to age 50 years the incidence rates of injurious fall events requiring medical attention were similar in men and women. At age 50 years, the incidence rates in women exceeded the rates in men and remained 1.2-1.8 times higher thereafter. After age 70 years, the rates increased exponentially in both sexes: from 27.4 and 49.3 per 1,000 person-years in men and women, respectively, to peaks of 112.8 and 170.8 per 1,000 person-years, respectively, at age 85 years and over. The proportion of falls occurring indoors and in institutional settings increased with advancing age. Compared with men, women had higher rates of fall-related contusions, distortions and fractures at all ages.
CONCLUSIONS: Fall-prevention programmes should be directed towards the population aged 70 years and over, in particular towards women and hazards in residential environments. Our finding of an increasing incidence of injurious fall events among women around the time of the menopause raises the hypothesis that loss of oestrogen production plays a role in the aetiology of falls in women.