The main objective of the proposed research is to determine if pads positioned over the hips in underpants pockets can reduce the incidence of hip fracture in elderly nursing home residents. Since 95% of these fractures result from a fall and impact of the hip with a hard surface, it is possible that force reducing pads can decrease impact force and fracture incidence. One thousand ambulatory residents of 14 Research Nursing Homes will be provided with padded underwear with a protective pad for only one hip. It is hypothesized that if the residents wear the padded underwear a large percentage of the time, that a statistically significant greater number of fractures will occur on the unpadded side. In such a study the patient becomes his/her own control for bone density; fall frequency; adherence; and for general aspects of health. Adherence failure will be monitored; causes identified; and strategies developed and implemented to increase adherence. Hip fracture costs the U.S. nine billion dollars a year and causes up to 100,000 deaths within one year. A simple, immediately effective, and inexpensive means of reducing fracture incidence would be a useful supplement or replacement for expensive pharmacotherapy directed at increasing bone density. PROPOSED COMMERCIAL APPLICATION: There are 25 million women over age 60, and 10 million men over age 70 with osteopenia or osteoporosis at risk for hip fracture. Those with very low bone density and persons who fall frequently have a significantly greater chance of fracture than those without such risk factors. We believe that frail nursing home residents and those at assisted living sites are also at great risk. We believe that there is a market of 40 million or more elderly who should use padded underware as a primary measure to reduce their risk of hip fracture. Three pair of pocketed underware and 2 pads can be provided a a net price of under $100.00 and may be used in addition to bone strengthening drug therapy without any significant toxic or irritant effects.