Background Menopaused and osteoporotic women have a higher risk of fractures when falling. Fall prevention is important when taking care of those women.
Objectives After identifying fall risk factors, defining the % of fractured fallers and the part of osteoporotic women in this population, we want to evaluate the relevance of balance tests and to favor prevention measures for those patients.
Methods 110 patients, 60 years and older (including 24 controls), having falled within a year, have seen 28 private practice rheumatologists in the larger Paris area and were subject of our multicentre retrospective study.
Results Fallers mean age was 75 years.
37% of the fallers within a year fractured after falling. Among them, 95% were post-menopausal fractures versus 64% when including the control group.
Post-fall or post menopausal fracture sites are identical. In order: spine 26%, wrist 18%, ribs 6%.
The circumstances of the falls are: 1) lack of attention 2) slipping 3) stumbling.
61% of the fallers have at least one physical activity, among them 71% a weight-bearing physical activity. The most common physical activity was walking (46%).
Among the fractured, 32% had physical activity, 42% hadn't.
72% of the fallers had at least one fall risk factor: 94% had intrinsic risk factors, 28% extrinsic, and an average of 2 risk factors within the older than 80 years.
Intrinsic factors: 1) osteo-articular 2) eye-vision 3) postural 4) drugs, out of 13 items.
Extrinsic: 1) obstacles 2) footwear out of 7 items.
45% of the fallers within a year had at least one osteoporosis risk factor: 1) low body mass index
2) cortico-steroids 3) early menopausis 4) smoking, out of 9 items.
70% of our patients had vitamin D level>30 ng/l (as recommanded)
69% of the patients had recent bone density measures: bone density was lower only at femoral neck of fractured fallers versus non fractured fallers.
The unipodal balance test (positive when standing less than 5 seconds) was relevant in 42% of the patients with or without fractures. Get up and go test was not relevant in our study population.
94% of the rheumatologists participating in the study recommend at least 2 fall prevention measures: 1) correct vitamin D levels 2) physical activity 3) reeducation 4) eye vision correction, out of 12 items.
Conclusions A significant part of menopaused women with anteriority of falls and fractures will refracture after falling again. Beside treating osteoporosis, we should identify potential fallers by doing unipodal tests, consider and correct fall risk factors, encourage those patients to keep on physical activity and prescribe reeducation.
Disclosure of Interest None declared
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