Grant: Operating Grant: Demonstration Projects in Mobility in Aging

In Canada, there are over 25,000 fall-related fractures at the hip annually with significant personal and societal consequences. Approximately 20% of people die within 12 months of fracturing and half do not regain their previous level of mobility. The decreased mobility leads to muscle weakness and an increased risk of falling; this combined with poor bone health can contribute to the risk of additional fractures. Consequently,understanding both falls risk factors and bone health are vital if we aim to improve outcomes and reduce injury after hip fracture. A 2002 U.S. National Consensus Conference illustrated a lack of coordination by care providers for seniors after a hip fracture, in particular, transition points between different phases along the continuum of care. We and others have also shown significant breakdowns in the recommended care pathway (post-discharge)after fall-related hip fracture. Recently, several publications have tested different strategies to improve follow-up care for seniors after hip fracture; some succeeded in improving investigation rates for osteoporosis.However, the prevention of future fractures requires assessment of both bone health and falls risk factors. Therefore, we aim to add a rather novel dimension to post-discharge hip fracture management by incorporating falls risk and bone health follow-up in a dedicated clinical service for older adults after hip fracture. Our objective is to test the effectiveness and cost-effectiveness of a comprehensive post-discharge hip fracture clinic to assess key health domains (bone health, balance,cognition and continence) that can contribute to future falls and injuries.