• Nicole D A Boyé, Francesco U S Mattace-Raso, Nathalie Van der Velde, Esther M M Van Lieshout, Oscar J De Vries, Klaas A Hartholt, Albert J H Kerver, Milko M M Bruijninckx, Tischa J M Van der Cammen, Peter Patka, Ed F Van Beeck, and IMPROveFALL trial collaborators.
• Section of Geriatric Medicine, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Surgery-Traumatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. Electronic address: n.boye@erasmusmc.nl.
• Injury. 2014 Aug 1;45(8):1224-30.

BackgroundFall-induced injuries in persons aged 65 years and older are a major public health problem. Data regarding circumstances leading to specific injuries, such as traumatic brain injury (TBI) and hip fractures in older adults are scarce.ObjectiveTo investigate the activity distributions leading to indoor and outdoor falls requiring an emergency department (ED) visit, and those resulting in TBIs and hip fractures.Participants5880 older adults who visited the ED due to a fall.MethodsData is descriptive and stratified by age and gender.ResultsTwo-thirds of all falls occurred indoors. However, there were higher proportions of outdoor falls at ages 65-79 years (48%). Walking up or down stairs (51%) and housekeeping (17%) were the most common indoor activities leading to a TBIs. Walking (42%) and sitting or standing (16%) was the most common indoor activities leading to a hip fracture. The most common outdoor activities were walking (61% for TBIs and 57% for hip fractures) and cycling (10% for TBIs and 24% for hip fractures).ConclusionIn the present study we found that the indoor activities distribution leading to TBIs and hip fractures differed. Notably, about half of the traumatic brain injuries and hip fractures in men and women aged 65-79 years occurred outdoors. This study provides new insights into patterns leading to injurious falls by age, gender and injury type, and may guide the targeting of falls prevention at specific activities and risk groups, including highly functional older men and women.Copyright © 2014 Elsevier Ltd. All rights reserved.

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