title: A long-recommended but seldom-used method of analysis for fall injuries found a unique pattern of risk factors in the youngest-old.
abstract: BACKGROUND
  Few studies on fall risk factors use long-recommended methods for analysis of recurrent events. Previous falls are the biggest risk factor for future falls, but few fall studies focus on the youngest-old.
  
  
  OBJECTIVE
  This study's objective was to apply Cox regression for recurrent events to identify factors associated with injurious falls in the youngest-old.
  
  
  METHODS
  Participants were community-dwelling residents of southern Sweden (n = 1,133), aged 59-67 at baseline (median 61.2), from the youngest cohorts of the larger Good Aging in Skåne (GÅS) study. Exposure variable data were collected from baseline study visits and medical records. Injurious falls, defined as emergency, inpatient, or specialist visits associated with ICD-10 fall codes during the follow-up period (2001-2011), were gathered from national and regional registries. Analysis was conducted using time to event Cox Regression for recurrent events.
  
  
  RESULTS
  A majority (77.1 %) of injurious falls caused serious injuries such as fractures and open wounds. Exposure to nervous system medications [hazard ratio (HR) 1.40, 95 % confidence interval (CI) 1.03-1.89], central nervous system disease (HR 1.79, CI 1.18-2.70), and previous injurious fall(s) (HR 2.00, CI 1.50-2.68) were associated with increased hazard of injurious fall.
  
  
  CONCLUSIONS
  Regression for recurrent events is feasible with typical falls' study data. The association of certain exposures with increased hazard of injurious falls begins earlier than previously studied. Different patterns of risk factors by age can provide insight into the progression of frailty. Tailored fall prevention screening and intervention may be of value in populations younger than those traditionally screened.
authors.affiliation: Department of Health Sciences, CRC, Skåne University Hospital, Jan Waldenströms gata 35, 205 02, Malmö, Sweden, helen.legrand@med.lu.se.
authors.forename: Helen
authors.initials: H
authors.lastname: Legrand
authors.forename: Mats
authors.initials: M
authors.lastname: Pihlsgård
authors.forename: Eva
authors.initials: E
authors.lastname: Nordell
authors.forename: Sölve
authors.initials: S
authors.lastname: Elmståhl
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data; D000368:Aged; D002491:Central Nervous System Agents / Q000627:therapeutic use; D002493:Central Nervous System Diseases / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology
chemical_list: D002491:Central Nervous System Agents