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Comparison of predictors of hip fracture and mortality after hip fracture in community-dwellers with and without Alzheimer's disease - exposure-matched cohort study.

https://arctichealth.org/en/permalink/ahliterature283663
Source
BMC Geriatr. 2016 Dec 01;16(1):204
Publication Type
Article
Date
Dec-01-2016
Author
Anna-Maija Tolppanen
Heidi Taipale
Antti Tanskanen
Jari Tiihonen
Sirpa Hartikainen
Source
BMC Geriatr. 2016 Dec 01;16(1):204
Date
Dec-01-2016
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Alzheimer Disease - epidemiology
Causality
Cohort Studies
Comorbidity
Demography
Female
Finland - epidemiology
Hip Fractures - epidemiology - mortality
Humans
Incidence
Independent Living - statistics & numerical data
Male
Proportional Hazards Models
Risk factors
Socioeconomic Factors
Abstract
Dementia, with Alzheimer's disease (AD) being the most common form, is a major hip fracture risk factor, but currently it is not known whether the same factors predict hip fracture among persons with and without dementia/AD. We compared the predictors of hip fracture and mortality after hip fracture in persons with and without AD.
An exposure-matched cohort of all community-dwellers of Finland who received a new clinically verified AD diagnosis in 2005-2011 and had no history of previous hip fracture (N = 67,072) and an age, sex, and region-matched cohort of persons without AD (N = 67,072). Associations between sociodemographic characteristics, comorbidities and medications and risk of hip fracture and mortality after hip fracture were assessed with Cox regression.
As expected, the incidence of hip fractures in 2005-2012 (2.19/100 person-years vs 0.90/100 person-years in the non-AD cohort), as well as mortality after hip fracture (29/100 person-years vs 23/100 person-years in the non-AD cohort) were higher in the AD cohort. This difference was evident regardless of the risk factors. Mental and behavioural disorders (adjusted hazard ratio; HR 95% confidence interval CI: 1.16, 1.09-1.24 and 1.71, 1.52-1.92 in the AD and non-AD-cohorts), antipsychotics (1.12, 1.04-1.20 and 1.56, 1.38-1.76 for AD and non-AD-cohorts) and antidepressants (1.06, 1.00-1.12 and 1.34 1.22-1.47 for AD and non-AD-cohorts) were related to higher, and estrogen/combination hormone therapy (0.87, 0.77-0.9 and 0.79, 0.64-0.98 for AD and non-AD-cohorts) to lower hip fracture risk in both cohorts. Stroke (1.42, 1.26-1.62), diabetes (1.13, 0.99-1.28), active cancer treatment (1.67, 1.22-2.30), proton pump inhibitors (1.14, 1.05-1.25), antiepileptics (1.27, 1.11-1.46) and opioids (1.10, 1.01-1.19) were associated with higher hip fracture risk in the non-AD cohort. Similarly, the associations between mortality risk factors (age, sex, several comorbidities and medications) were stronger in the non-AD cohort.
AD itself appears to be such a significant risk factor for hip fracture, and mortality after hip fracture, that it overrules or diminishes the effect of other risk factors. Thus, it is important to develop and implement preventive interventions that are suitable and effective in this population.
Notes
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PubMed ID
27908278 View in PubMed
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Declining incidence trends for hip fractures have not been accompanied by improvements in lifetime risk or post-fracture survival--A nationwide study of the Swedish population 60 years and older.

https://arctichealth.org/en/permalink/ahliterature271785
Source
Bone. 2015 Sep;78:55-61
Publication Type
Article
Date
Sep-2015
Author
Korinna Karampampa
Anders Ahlbom
Karl Michaëlsson
Tomas Andersson
Sven Drefahl
Karin Modig
Source
Bone. 2015 Sep;78:55-61
Date
Sep-2015
Language
English
Publication Type
Article
Keywords
Age Distribution
Age Factors
Aged
Aged, 80 and over
Cause of Death
Cohort Studies
Female
Fracture Healing
Hip Fractures - epidemiology - mortality
Humans
Incidence
Life expectancy
Male
Middle Aged
Registries
Risk factors
Sweden - epidemiology
Abstract
Hip fracture is a common cause of disability and mortality among the elderly. Declining incidence trends have been observed in Sweden. Still, this condition remains a significant public health problem since Sweden has one of the highest incidences worldwide. Yet, no Swedish lifetime risk or survival trends have been presented. By examining how hip fracture incidence, post-fracture survival, as well as lifetime risk have developed between 1995 and 2010 in Sweden, this study aims to establish how the burden hip fractures pose on the elderly changed over time, in order to inform initiatives for improvements of their health.
The entire Swedish population 60 years-old and above was followed between 1987 and 2010 in the National Patient Register and the Cause of Death Register. Annual age-specific hip fracture cumulative incidence was estimated using hospital admissions for hip fractures. Three-month and one-year survival after the first hip fracture were also estimated. Period life table was used to assess lifetime risk of hip fractures occurring from age 60 and above, and the expected mean age of the first hip fracture.
The age-specific hip fracture incidence decreased between 1995 and 2010 in all ages up to 94 years, on average by 1% per year. The lifetime risk remained almost stable, between 9% and 11% for men, and between 18% and 20% for women. The expected mean age of a first hip fracture increased by 2.5 years for men and by 2.2 years for women. No improvements over time were observed for the 3-month survival for men, while for women a 1% decrease per year was observed. The 1-year survival slightly increased over time for men (0.4% per year) while no improvement was observed for women.
The age-specific hip fracture incidence has decreased over time. Yet the lifetime risk of a hip fracture has not decreased because life expectancy in the population has increased in parallel. Overall, survival after hip fracture has not improved.
PubMed ID
25933944 View in PubMed
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Estimation of the lifetime risk of hip fracture for women and men in Canada.

https://arctichealth.org/en/permalink/ahliterature134642
Source
Osteoporos Int. 2012 Mar;23(3):921-7
Publication Type
Article
Date
Mar-2012
Author
R B Hopkins
E. Pullenayegum
R. Goeree
J D Adachi
A. Papaioannou
W D Leslie
J E Tarride
L. Thabane
Author Affiliation
Department of Clinical Epidemiology and Biostatistics, Faculty of Health Science, McMaster University, Hamilton, ON, Canada. hopkinr@mcmaster.ca
Source
Osteoporos Int. 2012 Mar;23(3):921-7
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Aged, 80 and over
Canada - epidemiology
Female
Hip Fractures - epidemiology - mortality
Humans
Life tables
Male
Middle Aged
Osteoporotic Fractures - epidemiology - mortality
Risk Assessment - methods
Sex Distribution
Abstract
In Canada in 2008, based on current rates of fracture and mortality, a woman or man at age 50 years will have a projected lifetime risk of fracture of 12.1% and 4.6%, respectively, and 8.9% and 6.7% after incorporating declining rates of hip fracture and increases in longevity.
In 1989, the lifetime risk of hip fractures in Canada was 14.0% (women) and 5.2% (men). Since then, there have been changes in rates of hip fracture and increased longevity. We update these estimates to 2008 adjusted for these trends, and in addition, we estimated the lifetime risk of first hip fracture.
We used national administrative data from fiscal year April 1, 2007 to March 31, 2008 to identify all hip fractures in Canada. We estimated the crude lifetime risk of hip fracture for age 50 years to end of life using life tables. We projected lifetime risk incorporating national trends in hip fracture and increased longevity from Poisson regressions. Finally, we removed the percentage of second hip fractures to estimate the lifetime risk of first hip fracture.
From April 1, 2007 to March 31, 2008, there were 21,687 hip fractures, 15,742 (72.6%) in women and 5,945 (27.4%) in men. For women and men, the crude lifetime risk was 12.1% (95%CI, 12.1, 12.2%) and 4.6% (95%CI, 4.5, 4.7%), respectively. When trends in mortality and hip fractures were both incorporated, the lifetime risk of hip fracture were 8.9% (95%CI, 2.3, 15.4%) and 6.7% (95%CI, 1.2, 12.2%). The lifetime risks for first hip fracture were 7.3% (95%CI, 0.8, 13.9%) and 6.2% (95%CI, 0.7, 11.7%).
The lifetime risk of hip fracture has fallen from 1989 to 2008 for women and men. Adjustments for trends in mortality and rates of hip fracture with removing second fractures produced non-significant differences in estimates.
PubMed ID
21557096 View in PubMed
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External validity of a population-based study on osteoporosis and fracture.

https://arctichealth.org/en/permalink/ahliterature102992
Source
Acta Orthop. 2014 Aug;85(4):433-7
Publication Type
Article
Date
Aug-2014
Author
Axel Wihlborg
Kristina Åkesson
Paul Gerdhem
Author Affiliation
Department of Clinical Science , Intervention and Technology, Karolinska Institutet, Department of Orthopedics, Karolinska University Hospital Huddinge , Stockholm.
Source
Acta Orthop. 2014 Aug;85(4):433-7
Date
Aug-2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Female
Follow-Up Studies
Fractures, Bone - epidemiology - mortality
Hip Fractures - epidemiology - mortality
Humans
Incidence
Kaplan-Meier Estimate
Longitudinal Studies
Osteoporosis - epidemiology - mortality
Pelvic Bones - injuries
Registries - statistics & numerical data
Reproducibility of Results
Risk factors
Shoulder Fractures - epidemiology - mortality
Spinal Fractures - epidemiology - mortality
Sweden - epidemiology
Abstract
Little is known about the characteristics of non-participants in epidemiological studies. We evaluated external validity by comparing fracture and mortality rate in participants and non-participants in a longitudinal study on risk factors for fracture.
1,604 randomly selected women, 75 years of age, were invited to attend a study on osteoporosis and fracture. 1,044 women attended the study (participants) and 560 women did not participate (non-participants). Fracture data for all were obtained prospectively from radiographic records. Mortality data were obtained through the population register. Mean follow-up was 13 (11-15) years. Cumulative survival was compared with the log-rank test. Fracture incidence rates per 1,000 person-years were compared with Mann-Whitney U-tests. In addition, fracture comparisons were made with the cumulative incidence function and Gray's test.
454 participants (44%) died during the follow-up, as compared to 372 of the non-participants (66%) (p
Notes
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PubMed ID
24847791 View in PubMed
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Falls and comorbidity: the pathway to fractures.

https://arctichealth.org/en/permalink/ahliterature105247
Source
Scand J Public Health. 2014 May;42(3):287-94
Publication Type
Article
Date
May-2014
Author
Terese Sara Høj Jørgensen
Annette Højmann Hansen
Marie Sahlberg
Gunnar H Gislason
Christian Torp-Pedersen
Charlotte Andersson
Ellen Holm
Author Affiliation
1Department of Geriatric Medicine, Nykøbing-Falster Hospital, Denmark.
Source
Scand J Public Health. 2014 May;42(3):287-94
Date
May-2014
Language
English
Publication Type
Article
Keywords
Accidental Falls - statistics & numerical data
Aged
Aged, 80 and over
Cause of Death - trends
Comorbidity
Databases, Factual
Dementia - epidemiology
Denmark - epidemiology
Depression - epidemiology
Diabetes Mellitus - epidemiology
Female
Heart Failure - epidemiology
Hip Fractures - epidemiology - mortality
Humans
Male
Myocardial Ischemia - epidemiology
Osteoporosis - epidemiology
Parkinson disease - epidemiology
Pulmonary Disease, Chronic Obstructive - epidemiology
Retrospective Studies
Risk factors
Shoulder Fractures - epidemiology - mortality
Stroke - epidemiology
Time Factors
Abstract
To compare nationwide time trends and mortality in hip and proximal humeral fractures; to explore associations between incidences of falls risk related comorbidities (FRICs) and incidence of fractures.
The study is a retrospective cohort study using nationwide Danish administrative registries from 2000 through 2009. Individuals aged 65 years or older who experienced a hip or a proximal humeral fracture were included. Incidence of hip and of proximal humeral fractures, incidence of FRICs (ischemic heart disease, COPD, dementia, depression, diabetes, heart failure, osteoporosis, Parkinson's disease and stroke) and incidence rate ratios (IRR) for fractures in patients with FRICs, and all-cause mortality up to 10 years after a hip or a proximal humeral fracture were analysed.
A total of 89,150 patients experienced hip fractures and 48,581 proximal humeral fractures. From 2000 through 2009, the incidence of hip fractures per 100,000 individuals declined by 198 (787 to 589, OR = 0.75, CI: 0.72-0.80) among males and by 483 (1758 to 1275, OR = 0.74, CI: 0.72-0.77) among females. Incidences of FRICs decreased. The absolute reduction in fractures was most pronounced for the age group above 75 years (2393 to 1884, OR = 0.81, CI: 0.78-0.83), but the relative reduction was more pronounced in the age group of 65-75 years old (496 to 342, OR = 0.70, CI: 0.66-0.74). IRRs for hip fractures and for proximal humeral fractures were significantly elevated in patients with FRICs.
The results suggest that the overall reduction in fractures can be explained by reduction in falls related comorbidity.
PubMed ID
24434943 View in PubMed
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Fractures of the hip: a three-year survey in one hospital, including experience with the Pugh nail procedure.

https://arctichealth.org/en/permalink/ahliterature248136
Source
J Am Geriatr Soc. 1978 Nov;26(11):506-9
Publication Type
Article
Date
Nov-1978
Author
S. Malkin
F. Frankenburg
Source
J Am Geriatr Soc. 1978 Nov;26(11):506-9
Date
Nov-1978
Language
English
Publication Type
Article
Keywords
Aged
Canada
Female
Fracture Fixation, Intramedullary - instrumentation
Hip Fractures - epidemiology - mortality - surgery
Humans
Joint Prosthesis
Male
Middle Aged
Postoperative Complications
Retrospective Studies
Abstract
Records were reviewed on 445 patients with fracture of the hip admitted to St. Paul's Hospital, Vancouver, Canada, during the period 1973--1975 inclusive. The epidemiologic factors were analyzed: age, sex, where and when the accident occurred, site of the fracture, the treatment procedure, length of time in hospital, complications, associated conditions, and final placement of the patient. Of the patients, 286 (64 percent) were more than 70 years of age. Among the 260 causal accidents in the patients' home living space or in the hospital, 35 involved toileting. The great majority of the fractured hips (330) were treated by open operation and internal fixation with the Pugh nail; the remainder were treated by conservative methods, various other devices, or arthroplasty. Within 30 days, 121 patients were discharged to their own homes and 68 to a major rehabilitation hospital. A total of 289 patients eventually returned to their own homes. The Pugh nail method of fixation permits early physiotherapy and early walking exercises, beginning within the first few days postoperatively. This largely accounts for the low complication rate, rapid achievement of functional status, and reduced hospital stay. Among the 445 patients there were 43 deaths, including 10 which occurred before operation could be undertaken.
PubMed ID
701702 View in PubMed
Less detail
Source
Ugeskr Laeger. 2008 Feb 18;170(8):619
Publication Type
Article
Date
Feb-18-2008
Author
Henrik Palm
Source
Ugeskr Laeger. 2008 Feb 18;170(8):619
Date
Feb-18-2008
Language
Danish
Publication Type
Article
Keywords
Denmark - epidemiology
Hip Fractures - epidemiology - mortality
Humans
PubMed ID
18364151 View in PubMed
Less detail

Hip fractures in a city in Northern Norway over 15 years: time trends, seasonal variation and mortality : the Harstad Injury Prevention Study.

https://arctichealth.org/en/permalink/ahliterature137772
Source
Osteoporos Int. 2011 Oct;22(10):2603-10
Publication Type
Article
Date
Oct-2011
Author
N. Emaus
L R Olsen
L A Ahmed
L. Balteskard
B K Jacobsen
T. Magnus
B. Ytterstad
Author Affiliation
Centre for Clinical Documentation and Evaluation, Northern Norway Regional Health Authority, Tromsø, Norway. nina.emaus@uit.no
Source
Osteoporos Int. 2011 Oct;22(10):2603-10
Date
Oct-2011
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Aged, 80 and over
Female
Hip Fractures - epidemiology - mortality
Humans
Incidence
Male
Middle Aged
Norway - epidemiology
Registries
Risk factors
Seasons
Sex Distribution
Abstract
In this open population-based study from Northern Norway, there was no increase in hip fracture incidence in women and men from 1994 to 2008. Age-adjusted hip fracture rates was lower compared to reported rates from the Norwegian capital Oslo, indicating regional differences within the country.
The aim of the present population-based study was to describe age- and sex-specific incidence of hip fractures in a Northern Norwegian city, compare rates with the Norwegian capital Oslo, describe time trends in hip fracture incidence, place of injury, seasonal variation and compare mortality after hip fracture between women and men.
Data on hip fractures from 1994 to 2008 in women and men aged 50 years and above were obtained from the Harstad Injury Registry.
There were altogether 603 hip fractures in Harstad between 1994 and 2008. The annual incidenc rose exponentially from 5.8 to 349.2 per 10,000 in men, and from 8.7 to 582.2 per 10,000 in women from the age group 50-54 to 90+ years. The age-adjusted incidence rates were 101.0 and 37.4 in women and men, respectively, compared to 118.0 in women (p?=?0.005) and 44.0 in men (p?=?0.09) in Oslo. The age-adjusted incidence rates did not increase between 1994-1996 and 2006-2008. The majority of hip fractures occurred indoors and seasonal variation was significant in fractures occurring outdoors only. After adjusting for age at hip fracture, mortality after fracture was higher in men than in women 3, 6 and 12 months (p?=?0.002) after fracture.
There are regional differences in hip fracture incidence that cannot be explained by a north-south gradient in Norway. Preventive strategies must be targeted to indoor areas throughout the year and to outdoor areas in winter.
Notes
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PubMed ID
21249333 View in PubMed
Less detail

Hip fractures in Finland and Great Britain--a comparison of patient characteristics and outcomes.

https://arctichealth.org/en/permalink/ahliterature71768
Source
Int Orthop. 2001;25(6):349-54
Publication Type
Article
Date
2001
Author
T. Heikkinen
M. Parker
P. Jalovaara
Author Affiliation
University of Oulu, University Hospital of Oulu, Department of Surgery, Finland.
Source
Int Orthop. 2001;25(6):349-54
Date
2001
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Comparative Study
Female
Finland - epidemiology
Great Britain - epidemiology
Hip Fractures - epidemiology - mortality - surgery
Humans
Length of Stay
Male
Reoperation
Treatment Outcome
Abstract
All hip fracture patients (age
PubMed ID
11820439 View in PubMed
Less detail

[Hip fractures: statistical data apropos of 195 cases treated at the Centre Hospitalier Fleury].

https://arctichealth.org/en/permalink/ahliterature248467
Source
Union Med Can. 1978 Jul;107(7):690-3
Publication Type
Article
Date
Jul-1978

18 records – page 1 of 2.