Stina Ek

Research problem and specific questions: Fall injuries among older adults are one of few public health problems that have not decreased with better health care and lifestyles, the number of falls will instead increase with an ageing population. A fall injury often leads to loss of independence and reduced quality of life. In addition, one fall often leads to more falls, leaving a vulnerable group of patients with increasing difficulty maintaining their independence.  Prognosis after a fall injury likely depends on an accumulation of sociodemographic- medical- and social factors. A combination of factors that either makes an individual vulnerable or resilient after a fall injury. Despite this, we know very little about the types of fall injuries that lead to more, worse injuries. In addition, the research focus is on individual risk factors for poor prognosis, lacking a focus on healthy factors and a real-world perspective that acknowledges health complexity and synergy of multiple factors.The aim of this project is to 1) identify the types of fall injuries that affect different groups of older people and which injuries lead to more fall injuries, identifying patterns of factors that make an individual 2) extra vulnerable after a fall, and 3) more resilient, who despite a fall injury regain independence.Data and method: Using a combination of national registries and survey data, we can follow individuals over many years to study patterns of fall injuries but also resilience after a fall injury in terms of medical care, medications, and home care. Using data on medical- and socio-economic factors - as well as personality and health behaviors in a sample of the older population - we can also get a picture of what characterizes vulnerability and resilience.Relevance: Fall injuries are the main cause of years with disability among people over 70 years in Sweden. The economic costs are high, with a fall leading to a serious injury costing the society around 273 600 SEK/person. Thus, falls among older adults are a major public health problem that will increase in magnitude and cost in the future. Our project will provide evidence to improve the prognosis after a fall injury, which can benefit both the individual and society.Plan for project realization: The project will be carried out at the Unit of Epidemiology, IMM, KI. We will use advanced machine learning methods to answer the research questions in linked national registers. The main cost is personnel costs.