Skip to main content
SpringerLink
Log in

Incidence and circumstances of falls among middle-aged women: a cohort study

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Summary

This was the first study assessing falls prospectively in middle-aged women. The 1-year incidence was 42% for any fall, which suggest falls are a major issue in middle-aged women. Middle-aged women, particularly those sustaining a fall, could be a target group for fall-prevention strategies.

Purpose

Incidence and circumstances of falls in middle-aged people are poorly understood. This cohort study aimed to elucidate the incidence and circumstances of falls over 1 year in middle-aged women.

Methods

Falls were recorded monthly for 1 year by questionnaire in 2017–2019 in a population-based sample of women aged 41–62 years. The incidence of falls and injurious falls and related circumstances were descriptively analysed.

Results

Of 273 women, 115 sustained 209 falls. The 1-year incidence was 42% for any fall, 17% for multiple (two or more) falls, and 24% for injurious falls. The incidence was greater in older age groups for any fall (33, 45, and 44% for people aged < 50, 50–55, and > 55 years, respectively), multiple falls (7, 14, and 22%) and injurious falls (15, 20, and 28%), although only the incidence of multiple falls was significantly increased across the three age groups (P = 0.01). Most falls occurred outdoors (71%) and were attributed to tripping and slipping (60%)

Conclusions

Falls are a major issue in middle-aged women, a group that has been largely ignored in the prevention of falls. Middle-aged women, in particular those sustaining a fall, could be a target group for fall-prevention strategies. Future studies are needed to identify risk factors for falling in this population so as inform the development of strategies for preventing falls in middle-aged women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. WHO (2018) Falls. https://www.who.int/en/news-room/fact-sheets/detail/falls. Accessed 17 November 2019

  2. Callisaya ML, Blizzard L, Schmidt MD, Martin KL, McGinley JL, Sanders LM, Srikanth VK (2011) Gait, gait variability and the risk of multiple incident falls in older people: a population-based study. Age Ageing 40:481–487

    Article  Google Scholar 

  3. Delbaere K, Close JC, Brodaty H, Sachdev P, Lord SR (2010) Determinants of disparities between perceived and physiological risk of falling among elderly people: cohort study. BMJ 341:c4165

    Article  Google Scholar 

  4. Deandrea S, Lucenteforte E, Bravi F, Foschi R, La Vecchia C, Negri E (2010) Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology 21:658–668

    Article  Google Scholar 

  5. Verma SK, Willetts JL, Corns HL, Marucci-Wellman HR, Lombardi DA, Courtney TK (2016) Falls and fall-related injuries among community-dwelling adults in the United States. PLoS One 11:e0150939

    Article  Google Scholar 

  6. Global Burden of Disease Collaborative Network (2018) Global Burden of Disease Study 2017 (GBD 2017) results. Seattle, USA: Institute for Health Metrics and Evaluation (IHME). http://ghdx.healthdata.org/gbd-results-tool. Accessed 20 November 2019

  7. Talbot LA, Musiol RJ, Witham EK, Metter EJ (2005) Falls in young, middle-aged and older community dwelling adults: perceived cause, environmental factors and injury. BMC Public Health 5:86

    Article  Google Scholar 

  8. Ablett AD, Wood AD, Barr R, Guillot J, Black AJ, Macdonald HM, Reid DM, Myint PK (2018) A high anticholinergic burden is associated with a history of falls in the previous year in middle-aged women: findings from the Aberdeen Prospective Osteoporosis Screening Study. Ann Epidemiol 28:557–562

    Article  Google Scholar 

  9. Caban-Martinez AJ, Courtney TK, Chang WR, Lombardi DA, Huang YH, Brennan MJ, Perry MJ, Katz JN, Christiani DC, Verma SK (2015) Leisure-time physical activity, falls, and fall injuries in middle-aged adults. Am J Prev Med 49:888–901

    Article  Google Scholar 

  10. Mackenzie L, Byles J, D’Este C (2006) Validation of self-reported fall events in intervention studies. Clin Rehabil 20:331–339

    Article  Google Scholar 

  11. Garcia PA, Dias JM, Silva SL, Dias RC (2015) Prospective monitoring and self-report of previous falls among older women at high risk of falls and fractures: a study of comparison and agreement. Braz J Phys Ther 19:218–226

    Article  Google Scholar 

  12. Hauer K, Lamb SE, Jorstad EC, Todd C, Becker C, Group P (2006) Systematic review of definitions and methods of measuring falls in randomised controlled fall prevention trials. Age Ageing 35:5–10

    Article  Google Scholar 

  13. Lamb SE, Jorstad-Stein EC, Hauer K, Becker C (2005) Development of a common outcome data set for fall injury prevention trials: the Prevention of Falls Network Europe consensus. J Am Geriatr Soc 53:1618–1622

    Article  Google Scholar 

  14. Winzenberg T, Oldenburg B, Frendin S, De Wit L, Jones G (2005) Effects of bone density feedback and group education on osteoporosis knowledge and osteoporosis self-efficacy in premenopausal women: a randomized controlled trial. J Clin Densitom 8:95–103

    Article  CAS  Google Scholar 

  15. Winzenberg T, Oldenburg B, Frendin S, De Wit L, Riley M, Jones G (2006) The effect on behavior and bone mineral density of individualized bone mineral density feedback and educational interventions in premenopausal women: a randomized controlled trial [NCT00273260]. BMC Public Health 6:12

    Article  Google Scholar 

  16. Wu F, Wills K, Laslett LL, Riley MD, Oldenburg B, Jones G, Winzenberg T (2018) Individualized fracture risk feedback and long-term benefits after 10 years. Am J Prev Med 54:266–274

    Article  Google Scholar 

  17. Women’s Health Concern (2017) The menopause. https://www.womens-health-concern.org/help-and-advice/factsheets/menopause/. Accessed 8 June 2020

  18. El Haber N, Erbas B, Hill KD, Wark JD (2008) Relationship between age and measures of balance, strength and gait: linear and non-linear analyses. Clin Sci (Lond) 114:719–727

    Article  Google Scholar 

  19. Choy NL, Brauer S, Nitz J (2003) Changes in postural stability in women aged 20 to 80 years. J Gerontol A Biol Sci Med Sci 58:525–530

    Article  Google Scholar 

  20. Martin KL, Blizzard L, Srikanth VK, Wood A, Thomson R, Sanders LM, Callisaya ML (2013) Cognitive function modifies the effect of physiological function on the risk of multiple falls--a population-based study. J Gerontol A Biol Sci Med Sci 68:1091–1097

    Article  Google Scholar 

  21. Greene BR, Doheny EP, Walsh C, Cunningham C, Crosby L, Kenny RA (2012) Evaluation of falls risk in community-dwelling older adults using body-worn sensors. Gerontology 58:472–480

    Article  Google Scholar 

  22. Lavedan A, Viladrosa M, Jurschik P, Botigue T, Nuin C, Masot O, Lavedan R (2018) Fear of falling in community-dwelling older adults: a cause of falls, a consequence, or both? PLoS One 13:e0194967

    Article  Google Scholar 

  23. Tromp AM, Pluijm SM, Smit JH, Deeg DJ, Bouter LM, Lips P (2001) Fall-risk screening test: a prospective study on predictors for falls in community-dwelling elderly. J Clin Epidemiol 54:837–844

    Article  CAS  Google Scholar 

  24. Peeters G, Cooper R, Tooth L, van Schoor NM, Kenny RA (2019) A comprehensive assessment of risk factors for falls in middle-aged adults: co-ordinated analyses of cohort studies in four countries. Osteoporos Int 30:2099–2117

    Article  CAS  Google Scholar 

  25. White AM, Tooth LR, Peeters G (2018) Fall risk factors in mid-age women: the Australian Longitudinal Study on Women’s Health. Am J Prev Med 54:51–63

    Article  Google Scholar 

  26. Hong GR, Cho SH, Tak Y (2010) Falls among Koreans 45 years of age and older: incidence and risk factors. J Adv Nurs 66:2014–2024

    PubMed  Google Scholar 

  27. Jang SN, Kawachi I, Chang J, Boo K, Shin HG, Lee H, Cho SI (2009) Marital status, gender, and depression: analysis of the baseline survey of the Korean Longitudinal Study of Ageing (KLoSA). Soc Sci Med 69:1608–1615

    Article  Google Scholar 

  28. Nevitt MC, Cummings SR, Kidd S, Black D (1989) Risk factors for recurrent nonsyncopal falls. A prospective study. JAMA 261:2663–2668

    Article  CAS  Google Scholar 

  29. Waldron N, Hill A, Barker A (2012) Falls prevention in older adults: assessment and management. Aust Fam Physician 41:930–935

    PubMed  Google Scholar 

  30. Callisaya ML, Blizzard L, McGinley JL, Srikanth VK (2012) Risk of falls in older people during fast-walking--the TASCOG study. Gait Posture 36:510–515

    Article  CAS  Google Scholar 

  31. Poss JW, Hirdes JP (2016) Very frequent fallers and future fall injury: continuous risk among community-dwelling home care recipients. J Aging Health 28:587–599

    Article  Google Scholar 

  32. Lord SR, Ward JA, Williams P, Anstey KJ (1993) An epidemiological study of falls in older community-dwelling women: the Randwick falls and fractures study. Aust J Public Health 17:240–245

    Article  CAS  Google Scholar 

  33. Bath PA, Morgan K (1999) Differential risk factor profiles for indoor and outdoor falls in older people living at home in Nottingham, UK. Eur J Epidemiol 15:65–73

    Article  CAS  Google Scholar 

  34. Li W, Keegan THM, Sternfeld B, Sidney S, Quesenberry CP, Kelsey JL (2006) Outdoor falls among middle-aged and older adults: a neglected public health problem. Am J Public Health 96:1192–1200

    Article  Google Scholar 

  35. Chan KM, Anderson M, Lau EMC (2003) Exercise interventions: defusing the world’s osteoporosis time bomb. Bull World Health Organ 81:827–830

    Google Scholar 

  36. Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, Macera CA, Heath GW, Thompson PD, Bauman A (2007) Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 39:1423–1434

    Article  Google Scholar 

  37. Physical Activity Guidelines Advisory Committee (2009) Physical Activity Guidelines Advisory Committee report, 2008. Nutr Rev 67:114–120

    Article  Google Scholar 

  38. Lord SR, Sherrington C, Menz HB, Close JCT (2007) Falls in older people: risk factors and strategies for prevention, 2nd edn. Cambridge University Press, New York

    Book  Google Scholar 

Download references

Acknowledgements

We thank all the volunteers and participants involved in the present study.

Funding

This work was supported by the National Health and Medical Research Council and a Menzies Institute for Medical Research NHMRC (the National Health and Medical Research Council) development grant. Feitong Wu is supported by a National Health and Medical Research Council Early Career Fellowship (APP1158661). Michele Callisaya is supported by a National Health and Medical Research Council Boosting Dementia Leadership Fellowship (APP1135761).

Author information

Authors and Affiliations

  1. Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia

    M. Wang, F. Wu, M. L. Callisaya, G. Jones & T. Winzenberg

  2. Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria, Australia

    M. L. Callisaya

Authors
  1. M. Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. F. Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. L. Callisaya
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G. Jones
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. T. Winzenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to F. Wu.

Ethics declarations

Conflict of interest

Mengmeng Wang, Feitong Wu, Michele L. Callisaya, Graeme Jones, and Tania Winzenberg declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical Standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

(PDF 22 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, M., Wu, F., Callisaya, M.L. et al. Incidence and circumstances of falls among middle-aged women: a cohort study. Osteoporos Int 32, 505–513 (2021). https://doi.org/10.1007/s00198-020-05617-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-020-05617-4

Keywords

Search

Navigation