The health-related quality of life and cost implications of falls in elderly women.
CONCLUSIONS
Fractures and falls are serious cause of morbidity and cost to society. Our results suggest that the main burden to morbidity, measured as impact on health-related quality of life, is due to fear of falling rather than falls or their sequelae, such as fractures.


BACKGROUND
Fractures and falls are serious cause of morbidity and cost to society. We investigated the impact on health-related quality of life (HRQoL) associated with falls, fractures and fear of falling and falls and fractures cost.


METHODS
Three datasets providing longitudinal data on fear of falling, HRQoL and a common set of baseline risk factors for fracture (smoking status, weight and age) were analysed. Multilevel random effects models were used to estimate the long-term impact on HRQoL associated with falls, fractures and fear of falling. Healthcare resource use primary data were collected to estimate falls and fractures cost.


RESULTS
Older, low weight and smoking women reported lower HRQoL. The impact on HRQoL of a fracture was at least twice as large as that associated with falls. The largest negative effect on HRQoL was associated with self-reported fear of falling. The cost of falls was 1088 pounds. Similarly, the cost of falls leading to a fracture was 15,133 pounds, 2,753 pounds, 1,863 pounds, 1,331 pounds and 3,498 pounds for hip, wrist, arm, vertebral and other fractures, respectively.


CONCLUSIONS
The main burden to morbidity is due to fear of falling. Interventions aimed at reducing fear of falling may produce larger gains in HRQoL.
Department of Health Sciences, University of York, Seebohm Rowntree Building Room 148, York YO10 5DD, UK. cpiu1@york.ac.uk
C P
CP
Iglesias
A
A
Manca
D J
DJ
Torgerson
D000058:Accidental Falls / Q000191:economics*; D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D005239:Fear / Q000523:psychology*; D005260:Female; D050723:Fractures, Bone / Q000191:economics / Q000453:epidemiology / Q000523:psychology*; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D011795:Surveys and Questionnaires