The role of falls in fracture prediction

Close to 75% of hip and non-hip fractures occur among seniors age 65 years and older. Notably, the primary risk factor for a hip fracture is a fall, and over 90% of all fractures occur after a fall. Thus, critical for the understanding and prevention of fractures at later age is their close relationship with muscle weakness and falling. In fact, antiresorptive treatment alone may not reduce fractures among individuals 80 years and older in the presence of nonskeletal risk factors for fractures despite an improvement in bone metabolism. This article will review the epidemiology of falls, and their importance in regard to fracture risk. Finally, fall prevention strategies and how these translate into fracture reduction are evaluated based on data from randomized controlled trials.