Addressing falls and fragility fractures in older adults is still necessary since they are associated with a long-term burden of disability and costs worldwide, i.e., increasing hospitalizations, post-hospital syndromes, mobility-disability, post-fall syndromes, and poor quality of life. However, we still need to discuss innovative methodologies and effective approaches to optimize the case finding, the decision-making and achieve patients’ goals and quality of life.
This is the time for a call to action that prioritizes the complexity of falls and fragility fracture management, building opportunities to include in the center of the discussion the orthogeriatric care model and the comprehensive interdisciplinary approach.
It is particularly important to discuss the patients’ risk stratification (i.e., fit, frail, disabled, or demented subjects) in the orthogeriatric care and rehabilitation programs, and the optimal outcomes obtained through an interdisciplinary healthcare program. Increasing interest regards procedures, structural and organizational aspects that may be associated with better outcomes (i.e. type of ward, professionals, protocols and procedures, minimum competencies, etc). In addition, more evidence about the efficacy and the sustainability of interventions for secondary prevention of falls and fragility fractures are required. Ultimately, there is a need to highlight the best pathway of care, related protocols and effects on main outcomes, which is the key component to support changes in the clinical practice and organization.
Intervention programs taking into account falls, fractures, and frailty are rising as the ICOPE, proposed by WHO, or the Fracture Liaison Services supported by IOF, and evidence from additional programs are welcome. Many methodological analytical flaws, lack of consensus about interventions, and actual constraints in the implementation of such programs have been argumented, therefore an updated summary of such issues is desidered within this collection. Aspects related with the clinical fisibility of available programs, their added value and the patients’ satisfaction, may also benefit all stakeholders.
With this collection at BMC Geriatrics, we are interested in attracting a wide range of submissions with a focus on the interplay of falls, fragility fractures, and orthogeriatrics. We strongly believe that fall and fragility fracture prevention is a critical milestone in the achievement of quality human longevity, and the interdisciplinary view may help to achieve better outcomes.
We are interested in evidences that highlight:
- the healthcare and the economic burden associated with falls and fragility fractures, worldwide;
- the importance of recognizing frailty as a condition associated or underlying falls and fragility fractures and the need for comprehensive appropriate assessment and interdisciplinary management of people living with falls and fragility fractures;
- the patients’ and systems’ gains associated with the orthogeriatric care management and interdisciplinary models of care after fragility fractures, from hospital admission to rehabilitation program outcomes (short and long-term);
- the increasing burden of peri-prosthesis fractures secondary to falls and the issues associated with surgical, rehabilitation and recovery of quality of life;
- the reasons for unsatisfaction or unfitness of available fall and fracture prevention programs in reaching desired goals;
- the opportunity and the impact of innovative fall and fracture program for secondary prevention to overcome the schism between “bench and bedside” evidence.