Objective. To evaluate risk factors for falls and fragility fractures in healthy seniors. Methods. Assessing 50 ambulatory community-dwelling volunteers ≥65 for demographics, BMI, bone mineral density (BMD) (DEXA), fracture risk (FRAX), balance (Biodex), fear of falling (Modified Falls Efficacy Scale (MFES)), and activity level (RAPA). One-year followup was done through phone interviews. Results. Most participants (17 males, 33 females; mean age years) had normal BMD and were active with little to no fear of falling. Balance did not correlate with FRAX or fear of falling. Activity level did not correlate with FRAX, but the active group had less fear of falling. Most scored below age specific norms on balance testing. Fear of falling was not significantly different between genders but did correlate with FRAX, indicating that patients with higher fracture risk were also more afraid of falling. Individuals who fell after one year had increased fear of falling and decreased activity levels. Conclusions. Community-dwelling seniors with higher risk of future fractures were more afraid of falling. Although healthy and active, this cohort had poor balance compared to age matched norms. Further research on how to best assess fall risk and improve balance to prevent fractures is needed. 1. Introduction Fractures resulting from a fall from standing height (fragility fractures) account for significant morbidity and health care expenses in older patients [1–3]. The 65-year and older age bracket is the fastest growing demographic around the world in both industrialized and developing countries [4, 5]. In industrialized countries, an estimated one-third of individuals ≥65 experience at least one fall each year [6, 7]. In 2008-2009, more than half of the cases of injurious falls were experienced by individuals 65, and within this age group, falls were responsible for 74% of major injuries suffered and approximately 10% to 15% resulted in fracture [8]. Regardless of whether a fracture occurs, falls can lead to a reduced quality of life and a functional decline for the individual [1, 7]. Falls in this age group are also more likely to result in longer and more expensive hospitalizations [1–3]. Annually, the cost to treat falls is 0.85% to 1.5% of the total health care expenditure [2, 3]. Fractures are the most costly result of falls; Stevens et al. found that although fractures accounted for only 35% of injuries sustained from falls, they were responsible for 61% of related health care costs [2]. Since a fracture event is determined both by risk of falling and bone
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