Continuously increasing number and incidence of fall-induced, fracture-associated, spinal cord injuries in elderly persons

Background: Although osteoporosis, falls, and fractures among older adults are said to be a continuously increasing public health problem, reliable epidemiological information on their secular trends is very limited. Objective: To determine the current trend in the number and incidence of fall-induced, fracture-associated, spinal cord injuries in a typical white population (Finland, a country with about 5 million inhabitants). Methods: All Finns aged 50 years or older who were admitted to hospitals from January 1, 1970, through December 31, 1995, for primary treatment of an acute fall-induced, fracture-associated, spinal cord injury were selected from the National Hospital Discharge Register. Similar patients aged 20 through 39 years served as a reference group. In each year of the study, the number and the age-specific and age-adjusted incidences of injuries were expressed as the number of patients per 100 000 persons. Results: The total number of fall-induced, fracture-associated, spinal cord injuries of Finnish older adults increased considerably during the study period, from 60 in 1970 to 419 in 1995 (an average increase of 24% annually). The corresponding injury incidence was 5 in 1970 and 27 in 1995. The age-adjusted incidence of these injuries also increased from 1970 to 1995: in women, from 5 to 29, and in men, from 7 to 17 (relative increases were 480% and 143%, respectively). In the reference group, no trend changes by time were observed. Conclusions: In Finnish persons aged 50 years or older, the number of fall-induced, fracture-associated, spinal cord injuries shows a rise with a rate that cannot be explained merely by demographic changes. The finding shows an increasing influence of osteoporosis and falls on health and well-being of our older adults, and therefore, vigorous preventive measures are needed to control this development.