National costs studied in the year after the fracture compared to the 6 months before the fracture were greatest in the initial 3 month period. The 65 and over group is projected to increase from 32 to 52 million by 2020 with a proportionate increase in these fractures. These costs can be expected to rise by at least 1.4 billion by 2020. Other studies have shown that fractures occur in those whose longest walk in the past month was half a block or less, or who fail to go outdoors and don't walk distances. Protective factors are a good hand-grip strength, and good ability to rise from a chair without using the arms.
Surprisingly alcoholics are less likely to fall than non-alcoholics .
Perhaps they have had practice at avoiding falls. Hormone replacement therapy is also important. Low bone mass, causing fracture susceptibility occurs more often in women compared to men and more in whites compared to blacks. Elderly white women should be screened for osteoporosis and treated to prevent osteoporosis. My wife has been screened and has increased her exercise and calcium intake but cannot take the hormone replacement because estrogens increase a clotting tendency and she has had two bouts of pulmonary emboli.