title: Differing trends in fall-related fracture and non-fracture injuries in older people with and without dementia.
abstract: To explore the impact of dementia on the trends in fall-related fracture and non-fracture injuries for older people.
  
  
  
  Individuals aged ≥65years who were admitted to a NSW hospital for at least an over-night stay for a fall-related injury from 2003 to 2012 were identified. Age-standardised hospitalisation rates, length of stay, access to in-hospital rehabilitation, 30-day and 1-year mortality were examined. Annual percentage change (PAC) over time was calculated using negative binomial regression.
  
  
  
  Of the 228,628 fall-related injury hospitalisations, 20.6% were for people with dementia. People with dementia were more likely to be admitted with a hip fracture, and less likely to be admitted with a fracture of the forearm/wrist, and received less in-hospital rehabilitation than people without dementia. Fall-related hip-fracture rates for people with dementia decreased by 4.2% (95%CI -5.6 to -2.7, p<0.001) per annum; there was no change over time for people without dementia (PAC-0.2%; 95%CI -0.8 to 0.5, p=0.643). Rates for other fractures decreased by 1.2% (95%CI -1.9 to -0.5, p<0.001) per annum in people with dementia, while rates increased by 2.2% (95%CI 1.9-2.5, p<0.001) for people without dementia. By contrast, non-fracture injuries including traumatic brain injury increased significantly for both people with and without dementia.
  
  
  
  Rates of fall-related fracture and non-fracture hospitalisations for people with dementia remain higher than for those without dementia. However, fall-related fracture hospitalisation rates have decreased for people with dementia, while there has not been a corresponding decrease in people without dementia.
authors.affiliation: Falls, Balance and Injury Research Centre, Neuroscience Research Australia, UNSW, Barker Street, Randwick, NSW 2031, Australia; School of Public Health and Community Medicine, UNSW, NSW 2052, Australia. Electronic address: l.harvey@neura.edu.au.
authors.forename: Lara
authors.initials: L
authors.lastname: Harvey
authors.affiliation: Falls, Balance and Injury Research Centre, Neuroscience Research Australia, UNSW, Barker Street, Randwick, NSW 2031, Australia; Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, NSW 2109 Australia, Australia. Electronic address: r.mitchell@mq.edu.au.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Mitchell
authors.affiliation: Dementia Collaborative Research Centre-Assessment and Better Care, UNSW, School of Psychiatry, Level 3, AGSM Building, UNSW, NSW 2052 Australia; Centre for Healthy Brain Ageing, School of Psychiatry, UNSW, Euroa Centre, School of Psychiatry UNSW Medicine, NSW 2031 Australia. Electronic address: h.brodaty@unsw.edu.au.
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
authors.affiliation: Dementia Collaborative Research Centre-Assessment and Better Care, UNSW, School of Psychiatry, Level 3, AGSM Building, UNSW, NSW 2052 Australia; Centre for Healthy Brain Ageing, School of Psychiatry, UNSW, Euroa Centre, School of Psychiatry UNSW Medicine, NSW 2031 Australia. Electronic address: b.draper@unsw.edu.au.
authors.forename: Brian
authors.initials: B
authors.lastname: Draper
authors.affiliation: Falls, Balance and Injury Research Centre, Neuroscience Research Australia, UNSW, Barker Street, Randwick, NSW 2031, Australia; Prince of Wales Clinical School, UNSW Medicine, NSW 2052 Australia. Electronic address: j.close@neura.edu.au.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Close
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D016022:Case-Control Studies; D003704:Dementia / Q000453:epidemiology*; D005260:Female; D005543:Forearm Injuries / Q000453:epidemiology* / Q000534:rehabilitation; D050723:Fractures, Bone / Q000453:epidemiology* / Q000534:rehabilitation; D006620:Hip Fractures / Q000453:epidemiology* / Q000534:rehabilitation; D006760:Hospitalization; D006801:Humans; D008297:Male; D012044:Regression Analysis; D014947:Wounds and Injuries; D014954:Wrist Injuries / Q000453:epidemiology* / Q000534:rehabilitation
keywords: Dementia; Falls; Hospitalisation; Injury