Most Fractures in Men Around Age 90 Follow Indoor, Low-Level Falls

Researchers analyzed fracture reports from 1,469 surviving participants in the US Osteoporotic Fractures in Men study. The men had a mean age of 90 years and were followed from March 2021 through November 2024. Fractures were confirmed using medical records, including radiographic reports, and participants or proxies were interviewed about the circumstances of each event. The analysis included 160 fall-related events among 143 men, resulting in 196 confirmed fractures.

Of 169 eligible clinical fracture events, 160 (94.7%) were fall-related. Most fall-related events involved a fall from standing height or less (88.1%); 70.6% occurred indoors, and 82.5% occurred when reported activity was normal or lower. Of indoor events, 82.3% took place in the participant’s own home. More than half of the events involved men who regularly used a walking aid, but in 42% of those cases the aid was not being used at the time of the fall.

The findings suggest that indoor falls warrant attention in research on fracture prevention for very old men. This observational study describes circumstances rather than evaluating interventions, so it cannot establish which prevention measures would reduce fractures. Its results may not generalize to younger men or populations outside this cohort.