Objective: To describe the incidence and associated factors of injury-causing falls by place of residence.
Design: A prospective population-based study.
Setting: Five municipalities in northern Finland.
Participants: All persons in the five communities aged 70 years or older living at home (n = 1016) and in long-term institutionalized care (n = 143).
Measurements: We recorded all fall incidents during a 2-year period by occurrence and severity of injury, using diary reporting and regular calls and by examining the medical and nursing records of all participants. The times, places, circumstances, and medical treatment needed were recorded as well.
Results: Men living at home experienced 71 minor injuries/1000 person years (PY), 42 major soft tissue injuries/1000PY, and 12 fractures/1000PY; women at home experienced 175 minor injuries/1000PY, 65 major soft tissue injuries/1000PY, and 33 fractures/1000PY. Institutionalized older men had 272 minor injuries/1000PY, 122 major soft tissue injuries/1000PY, and 41 fractures/1000PY; institutionalized women had 292 minor injuries/1000PY, 131 major soft tissue injuries/1000PY, and 58 fractures/1000PY. Falls causing injury to older adults in long-term institutionalized care were more evenly distributed by time of day than those that occurred at home. The majority of the injuries sustained in long-term institutionalized care were injuries to the head. The incidence rate of fall injuries requiring medical attention in women, 113/1000PY, was twice that in men, 57/1000PY.
Conclusions: Injury-causing falls are more frequent in older people living in long-term institutionalized care, and the time-distribution and some circumstances differ from those of injury-causing falls in home-dwelling older people.