One in Every 3 Seniors Will Fall

As baby boomers age, there is an expected increase in the geriatric population needing orthopaedic care. Ninety percent of the 350,000 hip fractures that occur each year in the U.S. are the result of a fall. Women have 2-3 times as many hip fractures as men, and have a 1 in 7 chance of hip fracture during their lifetimes. By the year 2050, there will be an estimated 650,000 hip fractures annually; nearly 1,800 hip fractures a day.

Hip fractures are one of the most devastating injuries, which often can lead to long-term hospitalization and even death. Today at a media briefing at the American Academy of Orthopaedic Surgeons 70th Annual Meeting in New Orleans, Kenneth J. Koval, MD, director of the orthopaedic trauma service and associate professor at NYU School of Medicine, released new data from a study of hip surgery patients over 65 conducted by the Hospital for Joint Diseases (HJD). "The goal in geriatric orthopaedics is to maximize independence and mobility in our older population," explained Dr. Koval. "Ongoing education about the serious consequences of a fall provides seniors with an opportunity to take preventive action now, and maintain health and independence for years to come."

The HJD Research Group studied patients 65 years or older who were in good health, ambulatory, and cognitively intact before the hip fracture. The researchers' goal was to determine both the fracture-oriented outcomes and the patient/function-oriented outcomes. The investigators also examined factors predictive of one-year mortality in previously independent elderly hip fracture patients.

In their study population, the HJD group found that, although the mortality status at one year revealed 83 percent living, 13 percent deceased, and 4 percent unknown, the functional outcomes of the patients were significantly reduced. The researchers looked at ambulation one year following hip fracture--independent, with cane, or using walker at home and in the community--and found that only 41 percent regained pre-fracture ambulation; the remaining 59 percent showed a decrease in independent walking ability.

In addition, the research team estimated the patients' total functional recovery by looking at individual BADLs (Basic Activities of Daily Living) and IADLs (Instrumental Activities of Daily Living). BADLs include such activities as bathing, eating, dressing, and toileting. IADLs include preparing shopping lists, shopping, cooking, and performing housework. The predictive factors for regaining BADL function were age 85 years or younger and living with another person; the predictive factor for recovering IADL function was 85 years or younger. In general, the researchers found that nearly three fourths of the patients regained BADLs by 12 months and 48 percent recovered IADLs by 12 months after the hip fracture.

Using this information, Koval was able to calculate the Functional Recovery Score (FRS) for geriatric hip fracture patients and explain to the seminar attendees the importance patients place on the different levels of function. This, in turn, also provides information about the prognosis for recovery and the role ambulation and daily living activities play in regaining quality of life after hip fracture.

The 26,047-member American Academy of Orthopaedic Surgeons (www.aaos.org) or (http://orthoinfo.aaos.org ), is a not-for-profit organization that provides education programs for orthopaedic surgeons, allied health professionals and the public. An advocate for improved patient care, the Academy is participating in the Bone and Joint Decade (http://www.usbjd.org ), the global initiative in the years 2002-2011 to raise awareness of musculoskeletal health, stimulate research and improve people's quality of life. President Bush has declared the years 2002-2011 National Bone and Joint Decade in support of these objectives. The Academy's Annual Meeting is being held February 5-9, 2003, at the Ernest N. Morial Convention Center.