Psychosocial factors associated with fall-related hip fractures

Background: fall-related injuries in older people are a major public health concern. This study examined the relationship between psychosocial determinants of healthy ageing and risk of fall-related hip fracture in community-dwelling older people. The purpose was to contribute evidence for promotion of healthy ageing strategies in population-based interventions for fall injury prevention. Methods: a case-control study was conducted with 387 participants, with at least two controls recruited per case. Cases of fall-related hip fracture in community-dwelling people aged 65 and older were recruited from hospital admissions in Brisbane, Australia, in 2003-2004. Community-based controls, matched by age, sex and postcode, were recruited via electoral roll sampling. A questionnaire assessing psychosocial factors, identified as determinants of healthy ageing, was administered at face-to-face interviews. Results: psychosocial factors having a significant independent protective effect on hip fracture risk included being currently married [OR: 0.44 (0.22 to 0.88)], living in present residence for 5 years or more [OR: 0.43 (0.22 to 0.84)], having private health insurance [OR: 0.49 (0.27 to 0.90)], using proactive coping strategies [OR: 0.52 (0.29 to 0.92)], having a higher level of life satisfaction [OR: 0.47 (0.27 to 0.81)], and engagement in social activities in older age [OR: 0.30 (0.17 to 0.54)]. Conclusion: this study suggests that psychosocial determinants of healthy ageing are protective in fall-related hip fracture injury in older people. Reduction in the public health burden caused by this injury may then be achieved by implementing healthy ageing strategies involving community-based approaches to enhance the psychosocial environments of older people.