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Our objective was to determine international estimates of the economic burden of falls in older people living in the community. Our systematic review emphasized the need for a consensus on methodology for cost of falls studies to enable more accurate comparisons and subgroup-specific estimates among different countries. The purpose of this study was to determine international estimates of the economic burden of falls in older people living in the community. This is a systematic review of peer-reviewed journal articles reporting estimates for the cost of falls in people aged ≥60 years living in the community. We searched for papers published between 1945 and December 2008 in MEDLINE, PUBMED, EMBASE, CINAHL, Cochrane Collaboration, and NHS EED databases that identified cost of falls in older adults. We extracted the cost of falls in the reported currency and converted them to US dollars at 2008 prices, cost items measured, perspective, time horizon, and sensitivity analysis. We assessed the quality of the studies using a selection of questions from Drummond’s checklist. Seventeen studies met our inclusion criteria. Studies varied with respect to viewpoint of the analysis, definition of falls, identification of important and relevant cost items, and time horizon. Only two studies reported a sensitivity analysis and only four studies identified the viewpoint of their economic analysis. In the USA, non-fatal and fatal falls cost US $23.3 billion (2008 prices) annually and US $1.6 billion in the UK. The economic cost of falls is likely greater than policy makers appreciate. The mean cost of falls was dependent on the denominator used and ranged from US $3,476 per faller to US $10,749 per injurious fall and US $26,483 per fall requiring hospitalization. A consensus on methodology for cost of falls studies would enable more accurate comparisons and subgroup-specific estimates among different countries. [ABSTRACT FROM AUTHOR]

Introduction: Fall risk is a major contributor to fracture risk; implementing fall reduction programmes remains a challenge for health professionals and policymakers. Materials and methods: We aimed to (1) ascertain whether the care received by 54 older adults after an emergency department (ED) fall presentation met internationally recommended 'Guideline Care', and (2) prospectively evaluate this cohort's 6-month change in fall risk profile. Participants were men and women aged 70 years or older who were discharged back into the community after presenting to an urban university tertiary-care hospital emergency department with a fall-related complaint. American Geriatric Society (AGS) guideline care was documented by post-presentation emergency department chart examination, daily patient diary of falls submitted monthly, patient interview and physician reconciliation where needed. Both at study entry and at a 6-month followup, we measured participants physiological characteristics by Lord's Physiological Profile Assessment (PPA), functional status, balance confidence, depression, physical activity and other factors. Results: We found that only 2 of 54 (3.7%) of the fallers who presented to the ED received care consistent with AGS Guidelines. Baseline physiological fall risk scores classified the study population at a 1.7 SD higher risk than a 65-year-old comparison group, and during the 6-month followup period the mean fall-risk score increased significantly (i.e. greater risk of falls) (1.7±1.6 versus 2.2±1.6, p=0.000; 29.5% greater risk of falls). Also, functional ability [100 (15) versus 95 (25), p=0.002], balance confidence [82.5 (44.4) versus 71.3 (58.7), p=0.000] and depression [0 (2) versus 0 (3), p=0.000] all worsened over 6 months. Within 6 months of the index ED visit, five participants had suffered six fall-related fractures. Discussion: We conclude that this group of community-dwelling fallers, who presented for ED care with a clinical profile suggesting a high risk of further falls and fracture, did not receive Guideline care and worsened in their fall risk profile by 29.5%. This gap in care, at least in one centre, suggests further investigation into alternative approaches to delivering Guideline standard health service. [ABSTRACT FROM AUTHOR]

The article offers information on the invitations made by journal editors, of the Core Outcomes in Women's (CROWN) health initiative, to researchers in the U.S. It states that journal editors invite them to lead in starting the scheme by developing core outcomes on women's health. Moreover, requirements on how to publish journals for the CROWN scheme are also mentioned.

The article cites a study about the perceived increase in the number of pulmonary infections due to Mycobacterium avium/intracellulare complex organisms in the U.S. Researchers examine whether this increase is associated with an increased application and sensitivity of diagnostic testing or with an actual increase in the number of infections. They investigate delayed hypersensitivity skin test data for participants in the National Health and Nutrition Examination Survey (NHANES) from 1971-1972 and from 1999-2000.

Fall related injuries and the resulting deaths in older adults are a major, and increasing, health problem world wide. About 30 percent of people over 65 years of age fall at least once a year, and about half of these do so recurrently. A fall may result in a fracture, particularly in an older person, and about 90 percent of hip fractures result from falls. The outcome of a hip fracture is fatal in 12-20 percent of cases. The annual cost of fall related fractures in the United States is estimated to be $10 billion. Furthermore, the incidence of hip fractures continues to rise steadily, even when age adjusted figures are used.