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)].


CONCLUSIONS
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.
Peel
Nancye M
NM
University of Queensland, Australasian Centre on Ageing, St Lucia, Queensland, Australia. n.peel@uq.edu.au
McClure
Roderick J
RJ
Hendrikz
Joan K
JK
D000058:Accidental Falls; D000223:Adaptation, Psychological; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D006620:Hip Fractures / Q000209:etiology / Q000523:psychology*; D006801:Humans; D007348:Insurance, Health; D008297:Male; D017533:Marital Status; D010549:Personal Satisfaction; D012111:Residence Characteristics; D012307:Risk Factors; D012959:Socioeconomic Factors