Incidence and consequences of accidental falls amongst well-functional community-dwelling older adults: Findings from the NOthern jutland Cohort of fall risk assessment with objective mesurement.

Introduction:
Falls amongst older adults are a major health problem and economic burden on the healthcare system, with 30% of older adults experiencing at least one fall per year. This study aims to document fall incidence and circumstances as well as fallrelated injuries in a well-functional group of community-dwelling older adults.

Method:
The NOCfao study is a prospective cohort study with a one-year follow-up on falls (1). Three hundred and thirty-two older adults were recruited for the study, with follow-up data of 284 (85,5%), mean age 76,5 (6,3), 82% female. At baseline, participants completed three questionnaires, performed selected physical tests, and wore an ankle-mounted pedometer for measuring physical activity for five consecutive days. Monthly fall incidences and circumstances were recorded throughout the one-year follow-up period.

Results:
Falls were reported by 34,2 percent of the participants of which 10,3 percent reported more than one fall. One hundred and fifty-nine falls were registered, eighty-two indoor. Forty-five percent of indoor and fifty-five percent of outdoor falls happened during walking activities. Of the fallers, twelve percent reported a fracture, all women. Seven out of ten fractures were related to the upper-extremity and occurred during outdoor walking activities (tripping accidents).

Conclusion:
This study showed a high fall incidence amongst an active and well-functioning group of community-dwelling older adults. Most falls occurred during indoor and outdoor walking activities. The majority of fractures located to the upper-extremity may indicate a preserved upper-extremity avoiding strategy. Targeting fall-related tripping-accident in existing training programs might reduce fall-related injuries