The question as to whether abdominal obesity has an adverse effect on hip fracture remains unanswered. The purpose of this study was to investigate the associations of waist circumference, hip circumference, waist-hip ratio, and body mass index with incident hip fracture.
The data in this prospective study is based on Cohort of Norway, a population-based cohort established during 1994-2003. Altogether 19,918 women and 23,061 men aged 60-79 years were followed for a median of 8.1 years. Height, weight, waist and hip circumference were measured at baseline using standard procedures. Information on covariates was collected by questionnaires. Hip fractures (n = 1,498 in women, n = 889 in men) were identified from electronic discharge registers from all general hospitals in Norway between 1994 and 2008.
The risk of hip fracture decreased with increasing body mass index, plateauing in obese men. However, higher waist circumference and higher waist-hip ratio were associated with an increased risk of hip fracture after adjustment for body mass index and other potential confounders. Women in the highest tertile of waist circumference had an 86% (95% CI: 51-129%) higher risk of hip fracture compared to the lowest, with a corresponding increased risk in men of 100% (95% CI 53-161%). Lower body mass index combined with abdominal obesity increased the risk of hip fracture considerably, particularly in men.
Abdominal obesity was associated with an increased risk of hip fracture when body mass index was taken into account. In view of the increasing prevalence of obesity and the number of older people suffering osteoporotic fractures in Western societies, our findings have important clinical and public health implications.
BACKGROUND: Low levels of physical activity is associated with major health problems. However, no overview of the level of physical activity outside work or school in Norway has been made, which is important in order to implement targeted interventions. MATERIAL AND METHODS: Based on published as well as unpublished data, we present data on physical activity in Norway--among children and adolescents, adults and elderly people. RESULTS: Results from different studies differ markedly. However, the main findings are these: The level of physical activity increases in childhood up until about 13 years of age. Approximately 70% of adolescents are active two hours or more a week beyond school-hours. The proportion of physical active youngsters then decreases towards young adulthood. Adults and elderly people get more inactive with increasing age. Data on physical activity from the past 10-15 years suggest a slight increase in the proportion of moderately active Norwegians. INTERPRETATION: Research on physical activity is impeded by the fact that different studies have operationalized physical activity differently and used different age grouping. There is a need for surveys in representative samples with standardised and validated questions, with uniform age classification, covering the full spectre of physical activity. In addition, we need smaller studies with more comprehensive measures of physical activity in Norway.
The association between alcohol consumption and hip fracture differed by gender: Men aged 30-59 years drinking frequently or 14+ gl/week had higher risk than moderate drinkers. No significant association was seen in older men. Women not drinking alcohol had higher risk than those drinking moderately both regarding frequency and amount.
We aimed to examine alcohol consumption and risk of hip fracture according to age and gender in the population-based Cohort of Norway (1994-2003).
Socio-demographics, lifestyle, and health were self-reported and weight and height were measured in 70,568 men and 71,357 women =?30 years. Information on subsequent hip fractures was retrieved from hospitals' electronic patient registries during 1994-2013. Frequency of alcohol consumption was categorized: never/seldom, moderate (=?2-3 times/week), or frequent (=?4 times/week), and amount as number of glasses per week: 0, 1-6, 7-13, 14-27, and 28+. Type of alcohol (wine vs. beer/hard liquor) was also examined. Cox's proportional hazards regression was used to estimate hazard ratios (HRs) stratified on gender and baseline age
Fracture incidence in Oslo decreased from the 1970s to the 1990s in younger postmenopausal women, but not in older women or in men. Concurrently, hormone replacement therapy increased considerably. Using data from the Oslo Health Study, we estimated that roughly half the decline might be attributed hormone replacement therapy. INTRODUCTION: Between the late 1970s and the late 1990s, the incidence of hip fracture and distal forearm fracture decreased in younger postmenopausal women in Oslo, but not in elderly women or in men. The purpose of this report is to evaluate whether the decreased incidence was coherent with trends in use of hormone replacement therapy (HRT). METHODS: Data on estrogens were collected from official drug statistics, data on fractures from published studies and data on bone mineral density (BMD) from the Oslo Health Study. RESULTS: The sale of all estrogens increased 22 times from 1979 to 1999, and the sub-category estradiol combined with progestin increased 35 times. In the corresponding period the incidence of distal forearm fracture in women aged 50-64 years decreased by 33% and hip fracture by 39%. Based on differences in BMD between users and non-users of HRT, we estimated that up to half of this decline might be due to HRT. CONCLUSIONS: The reduction in fracture incidence in postmenopausal women in Oslo occurred in a period with a substantial increase in the use of HRT. Future surveillance will reveal whether the last years' decline in use of HRT will be translated into increasing fracture rates.
The present study investigated the risk of incident hip fractures according to serum concentrations of vitamin K1 and 25-hydroxyvitamin D in elderly Norwegians during long-term follow-up. The results showed that the combination of low concentrations of both vitamin D and K1 provides a significant risk factor for hip fractures.
This case-cohort study aims to investigate the associations between serum vitamin K1 and hip fracture and the possible effect of 25-hydroxyvitamin D (25(OH)D) on this association.
The source cohort was 21,774 men and women aged 65 to 79 years who attended Norwegian community-based health studies during 1994-2001. Hip fractures were identified through hospital registers during median follow-up of 8.2 years. Vitamins were determined in serum obtained at baseline in all hip fracture cases (n?=?1090) and in a randomly selected subcohort (n?=?1318). Cox proportional hazards regression with quartiles of serum vitamin K1 as explanatory variable was performed. Analyses were further performed with the following four groups as explanatory variable: I: vitamin K1?=?0.76 and 25(OH)D?=?50 nmol/l, II: vitamin K1?=?0.76 and 25(OH)D?
The present study describes the amount and distribution of communication on dental health issues in Norwegian adults. The empirical data stem from a representative sample of Norwegians aged 15 and above, and were collected by means of personal interviews by the poll organization Norges Markedsdata in 1983. Edentulous subjects were excluded, and the study group finally comprised 1225 subjects. The dependent variable - dental communication - was a dichotomy based upon whether or not the respondents had communicated with friends about dental health during the last 6 months. The following independent variables were used: age, sex, marital status, education, use of dental services, number of teeth, knowledge of prevention, information about dental health from dentists and media, use of dental floss and toothpicks. The empirical analysis was performed using contingency table analysis and Multiple Classification Analysis (MCA). Separate analyses were performed for men and women. Significantly more women (27.6%) than men (14.5%) reported dental communication. In addition, the model provided a better fit to the data on women compared to men in terms of R2 (12.5% and 8.9%). These observations can to some extent be accounted for by the existing sex-role pattern. The only predictor which showed a consistent direct effect across sex was whether the respondents had received information about dental health from media. This means that reference to the interpersonal context of mass communication perhaps best describes the complex transactional interplay of media and interpersonal sources in dental health matters.
OBJECTIVES: To investigate compliance with hip protector use. DESIGN: Observational prospective study. SETTING: 19 nursing homes (1040 beds). SUBJECTS: All residents during an 18 month period were included in this study. INTERVENTION: Hip protectors were introduced as a regular part of health care service for all residents. Residents at high risk were encouraged to use hip protectors regularly. Each nursing home had a contact person. MAIN OUTCOME MEASURES: The percentage of residents accepting the hip protector offer, probability of continued use, reasons for terminating use, and percentage of falls with hip protector were evaluated. RESULTS: Fifty five percent of the residents accepted the hip protector offer. The percentage increased by age, but showed no significant dependence on gender, profession of the contact person, or size of nursing home. The probability of continued use showed no significant dependence on age and gender. Nursing homes with a nurse as contact person showed 51% higher risk of residents terminating regular hip protector use than nursing homes with a physiotherapist as contact person (relative risk (RR) 1.51, 95% confidence interval (CI) 1.11 to 2.05, p = 0.008). The corresponding result for large (75-92 beds) compared with small (24-68 beds) nursing homes was RR = 1.44 (95% CI 1.02 to 2.02, p = 0.036). Seventy six percent of 2323 falls occurred while using hip protectors. CONCLUSION: The contact person and size of the nursing home seemed to be important factors for continued use of hip protectors while age and gender seemed to be less important.
The previously reported decline in age-adjusted hip fracture rates in Norway during 1999-2008 continued after 2008. The annual number of hip fractures decreased in women and increased in men.
Norway has among the highest hip fracture incidence rates ever reported despite previously observed declining rates from 1999 through 2008. The aim of the present study was to investigate whether this downward trend continued through 2013, and to compare gender-specific trends in 5 year age-groups during three time periods: 1999-2003, 2004-2008, and 2009-2013.
All hip fractures (cervical, trochanteric, and sub-trochanteric) admitted to Norwegian hospitals were retrieved. Annual age-standardized incidence rates of hip fracture per 10,000 person-years by gender were calculated for the period 1999-2013. Time trends were tested by age-adjusted Poisson regression.
From 1999 through 2013 there were 140,136 hip fractures in persons aged 50 years and above. Age-adjusted hip fracture incidence rates declined by 20.4 % (95 % CI: 18.6-20.1) in women and 10.8 % (95 % CI: 7.8-13.8) in men, corresponding to an average annual age-adjusted decline of 1.5 % in women and 0.8 % in men. Except for the oldest men, hip fracture rates declined in all age-groups 70 years and older. The average annual number of fractures decreased in women (-0.3 %) and increased in men (+1.1 %).
During the past 15 years, hip fracture rates have declined in Norway. The forecasted growing number of older individuals might, however, cause an increase in the absolute number of fractures, with a substantial societal economic and public health burden.
Cites: J Bone Miner Res. 2012 Nov;27(11):2325-32 PMID 22692958