The Downton Fall Risk Index may predict fractures related to falls and osteoporosis in older men and women, suggest data presented at the American Society for Bone and Mineral Research (ASBMR) 2014 Annual Meeting.

“Fall risk assessment instruments predict falls but it is unknown to what extent they predict serious health outcomes such as hip fracture,” the researchers wrote in their abstract.

To learn more, researchers in Sweden analyzed the ability of the Downton Fall Risk Index to predict fall-related hip fractures or osteoporotic fractures in the elderly. The index is a composite index of 11 established risk factors for falls.

Continue Reading

They calculated the predictive role of the index using a Cox proportional hazards model that included age, sex, height, weight and prevalent osteoporotic fracture as covariates. They also accounted for time to outcome or end of study.

A total of 128,596 elderly patients (mean age, 82.4 years; 59.6% women) who underwent Downton Fall Risk Index risk assessment were included in the analysis. Of these, 6,699 experienced an osteoporotic fracture — 2,557 of whom had a hip fracture — during more than 80,000 patient-years of follow-up.

A high Downton Fall Risk Index score, defined as 7 to 11, was associated with a three-fold higher incidence of hip fracture vs. a low score, defined as 0 or 1, (3.2% vs. 1.1%; P<.001), according to the data.

Downton Fall Risk Index also appeared to independently predict osteoporotic fracture (HR per Downton Fall Risk Index-step=1.06; 95% CI, 1.05-1.17) and hip fracture (HR=1.14; 95% CI, 1.11-1.16). Hip fracture prediction with the Downton Fall Risk Index was stronger in those aged 70 years vs. 90 years (HR=1.33 vs. 1.09; P<.001).

“Our data provide evidence that fall risk assessment using [Downton Fall Risk Index] independently predicts fall-related hip fracture and other osteoporotic fractures in older men and women, indicating its clinical usefulness to identify patients who would benefit from interventions,” the researchers concluded.


  1. Nilsson M et al. Abstract 1012. Presented at: American Society for Bone and Mineral Research 2014 Annual Meeting; Sept. 12-15, 2014; Houston, Texas.