title: Reduction of femoral fractures in long-term care facilities: the Bavarian fracture prevention study.
abstract: BACKGROUND
  Hip fractures are a major public health burden. In industrialized countries about 20% of all femoral fractures occur in care dependent persons living in nursing care and assisted living facilities. Preventive strategies for these groups are needed as the access to medical services differs from independent home dwelling older persons at risk of osteoporotic fractures. It was the objective of the study to evaluate the effect of a fall and fracture prevention program on the incidence of femoral fracture in nursing homes in Bavaria, Germany.
  
  
  METHODS
  In a translational intervention study a fall prevention program was introduced in 256 nursing homes with 13,653 residents. The control group consisted of 893 nursing homes with 31,668 residents. The intervention consisted of staff education on fall and fracture prevention strategies, progressive strength and balance training, and on institutional advice on environmental adaptations. Incident femoral fractures served as outcome measure.
  
  
  RESULTS
  In the years before the intervention risk of a femoral fracture did not differ between the intervention group (IG) and control group (CG). During the one-year intervention period femoral fracture rates were 33.6 (IG) and 41.0/1000 person years (CG), respectively. The adjusted relative risk of a femoral fracture was 0.82 (95% CI 0.72-0.93) in residents exposed to the fall and fracture prevention program compared to residents from CG.
  
  
  CONCLUSIONS
  The state-wide dissemination of a multi-factorial fall and fracture prevention program was able to reduce femoral fractures in residents of nursing homes.
authors.affiliation: Department of Clinical Gerontology, Robert-Bosch-Hospital, Stuttgart, Germany. clemens.becker@rbk.de
authors.forename: Clemens
authors.initials: C
authors.lastname: Becker
authors.forename: Ian D
authors.initials: ID
authors.lastname: Cameron
authors.forename: Jochen
authors.initials: J
authors.lastname: Klenk
authors.forename: Ulrich
authors.initials: U
authors.lastname: Lindemann
authors.forename: Sven
authors.initials: S
authors.lastname: Heinrich
authors.forename: Hans-Helmut
authors.initials: HH
authors.lastname: König
authors.forename: Kilian
authors.initials: K
authors.lastname: Rapp
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005264:Femoral Fractures / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D008134:Long-Term Care / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D009735:Nursing Homes