Falls are among the most common and serious problems facing older persons and are associated with considerable morbidity and mortality. They often lead to reduced functioning and nursing home admissions. The incidence of falls as well as the severity of fall-related complications rises steeply beyond the age of 60 years. Among all community dwelling persons of 65 years and over, 30-40% have at least one fall each year. The incidence of falls in nursing homes and hospitals is almost 3 times as high as in the community. Not all falls of older adults result in injury, but 4% to 5% of the falls cause a fracture, and an additional 5% to 11% of falls cause other serious injuries, e.g., serious soft tissue contusions, joint distortions and dislocations, severe wounds and lacerations, and head injuries. Unintentional injuries are the fifth leading cause of death in older adults, and falls are responsible for two-thirds of the deaths resulting from unintentional injuries. A number of studies have identified risk factors for falling. A commonly used classification for falls distinguishes between intrinsic, extrinsic and environmental factors. The risk of falling, i.e., the chance to experience one or more falls per year, increases dramatically if the number of risk factors increases. Polypharmacy (defined as the use of four or more medications) is regarded as an important risk factor for falling in the elderly. To reduce the fall risk within the older population all risk factors need to be assessed. Special efforts should be made to identify modifiable risk factors which can be useful for undertaking effective interventions. In this thesis, investigations are described concerning the occurrence and consequences of falls in the Netherlands, to address risk factors for falls and to explore the association of drug use with falls and fall related fractures in more depth. Main analyses were performed in the Rotterdam Study, a prospective population-based cohort study. Additionally, the ‘Landelijke Medische Registratie’ (LMR) database was used, a registry that stores discharge information from all hospitalizations in the Netherlands. Both data sources could be combined by record linkage.

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Erasmus University Rotterdam
Stricker, Prof. Dr. B.H.Ch. (promotor) The Netherlands Organization for Scientific Research The Netherlands Organization for Health Research and Development The Research Institute for Diseases in the Elderly The Ministry of Education, Culture and Science The Ministry of Health, Welfare and Sports The European Commission The Municipality of Rotterdam
Erasmus MC: University Medical Center Rotterdam

Ziere, G. (2007, December 5). Risk Factors for Falls and Fall-related Fractures in the Elderly. Erasmus University Rotterdam. Retrieved from http://hdl.handle.net/1765/10737