The ageing of Western populations increases the incidence of people with hip fractures, with corresponding expectations of decline in function or mortality. By 2050 the worldwide annual incidence of hip fractures among elderly people will be 4.5 million,1 and prevention will be more important than ever.

There are three main pathways to preventing hip fracture. Firstly, Close and colleagues found in a randomised trial among community dwelling elderly people with recurrent falls that an interdisciplinary approach significantly reduced the risk of further falls.2 Patients assigned to the intervention group underwent a detailed medical and occupational-therapy assessment with referral to relevant services. Secondly, most hip fractures are due to osteoporosis, which is treatable. Frail elderly people may prefer, however, to avoid the possible adverse effects of osteoporosis drugs and to use non-pharmacological strategies to decrease the risk of hip …