Preventing femoral fractures among elderly: The community safety approach

The current picture of fatal injuries in Sweden is dominated by falls, which account for about 40%. Furthermore, falls are by far the most dominating cause of hospital in-patient care (57%). The aetiologic mechanisms behind falls and fractures are complicated, with a multifactorial causal pattern.The Lidköping Accident Prevention Programme — one of the few comprehensive community intervention programs in the world — provides an opportunity to discuss links between a multifactorial intervention program and related injuries in the elderly. The incidence of femoral fractures in Lidköping shows a significantly declining trend for females (− 6.6% per year) and a − 5.4% decline for males during the study period of 1987–1992. The control area of Skaraborg County showed a minor decrease and Sweden as a whole showed an increasing trend during the same period.In spite of the methodological problems of attributing effects in quasi-experiments, there is some support for the claim that the declining trend in the trial area was largely the result of the intervention program. This conclusion is further strengthened by the recently published report from the USA showing that a multiple-risk-factor intervention strategy resulted in a significant reduction in the risk of falling among elderly persons in the community.