title: Patterns in health-related behaviours and fall injuries among older people: a population-based study in Stockholm County, Sweden.
abstract: OBJECTIVE
  we identified clusters of older people with similar health-related behaviours and assessed the association between those clusters and the risk of injurious fall.
  
  
  METHODS
  we linked self-reported and register-based data on the over-65s from the Stockholm public health cohort (N = 20,212). Groups of people with similar health-related behaviours were identified by cluster analysis using four measures of physical activity, two of smoking and alcohol habits and two individual attributes (age and type of housing). The association between clusters and falls leading to hospitalisation (422 cases) was studied using a nested case-control design. Odds ratios (ORs), crude and adjusted for health status, were compiled by cluster using the one with the most 'protective' health behaviour profile as the reference.
  
  
  RESULTS
  five clusters were identified revealing a variety of combinations of health-related behaviours, all linked to specific age groups and types of housing and with a tendency towards higher levels of physical activity among the younger ones. The risk of injurious falls differed across clusters, and for three out of four, it was significantly higher than in the comparison cluster. Adjusting for health status only partially reduced the ORs for those clusters and this was observed both in men and women.
  
  
  CONCLUSIONS
  health-related behaviours aggregate in different manners among older people. Some health-related profiles are associated with an excess risk of falls leading to hospitalisation. Although this is partly a reflection of age differences across clusters, health status alone cannot fully explain the association.
authors.affiliation: Department of Public Health Sciences, Division of Public Health Epidemiology, Karolinska Institutet, Stockholm, Sverige, Sweden.
authors.forename: Bjorg
authors.initials: B
authors.lastname: Helgadottir
authors.affiliation: Department of Public Health Sciences, Division of Public Health Epidemiology, Karolinska Institutet, Stockholm, Sverige, Sweden.
authors.forename: Jette
authors.initials: J
authors.lastname: Moller
authors.affiliation: Department of Public Health Sciences, Division of Global Health/IHCAR, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Lucie
authors.initials: L
authors.lastname: Laflamme
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016000:Cluster Analysis; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D011159:Population Surveillance; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D057566:Self Report; D013548:Sweden / Q000453:epidemiology
keywords: alcohol use; follow-up; health status; older people; physical activity; smoking