More Elderly Women than Men Experience Falls and Hip Fractures

Hip fractures are highly prevalent among the elderly population in the United States. An estimated 1.6 million older adults (those over 50 years of age) experience a hip fracture every year.  This type of injury causes severe debilitation and significantly hinders an individual’s ability to carry out activities of daily living (i.e. bathing, dressing). According to an article published in the Journal of the American Medical Directors Association, hip fractures occur at least twice as often in elderly women than in elderly men, which have traditionally been attributed to women having lower bone density. However, new studies show that difference in bone density, and therefore osteoporosis, is not enough to explain the higher incidence of fractures in women than their male counterparts.  Researchers sought to investigate other underlying factors that contribute to fracture, such as vulnerability of falling, especially due to the fact that 90% of hip fractures result from falls.

According to the article, “women report more falls and experience more fall-related injuries than men.”  However, the mechanisms underlying this difference are unclear and in need of more research. Increased difference in gait patterns has been hypothesized to be a marker of fall risk in older adults, “especially during ambulation under dual-task conditions.” Such circumstances are believed to make performing executive functions more challenging—specifically, the ability to plan and execute motor and cognitive processes at the same time is more difficult for older adult women than men.

A recent study explored the differences in gait patterns among 1390 men and women who were at least 70 years of age during progressively more difficult gait conditions. The study also aimed to find relationships between gender and gait patterns and the risk of fall incidents.

The researchers measured gait patterns of the participants using a computerized walkway system during normal and fast speeds, as well as dual-task trials. During the follow-up period of the study, 148 older adult participants reported fall incidents. The study also found that there were higher variations in gait pattern among fallers compared with those who had not fallen during the dual-task trial. Moreover, women had up to 35% more variability in gait patterns during the dial-task trial compared with men.

The study concluded that in the present cohort, women at least 70 years of age were more vulnerable to falls compared with their male counterparts.  Their increased vulnerability was related to increased difference in gait pattern during dual-task activities.  Furthermore, researchers proposed that this may contribute to the heightened facture risk in women compared with men.

It is well known that older adults in nursing homes and assisted living facilities are often frail and at high risk of falls.  Staff of these facilities must be aware of the risk factors that put their patients in danger of experiencing fractures and should provide the proper care and assistive devices to lower that risk. A fall can cause extreme debilitation and greatly reduce quality of life for an older adult. Taking the proper measures to decrease fall risk as much as possible is crucial to protect patients from experiencing such a tragic event.