Site-specific relative risk of fractures in the institutionalized elderly.
A 3-year prospective study was performed to evaluate the incidence of fractures in institutionalized elderly and associated risk factors. A total of 197 subjects (47 males and 150 females, mean age 81.5 +/- 8.0 years) were included in the study. The annual fracture incidence was 7.8%. All hip fractures occurred in female subjects (annual incidence = 3.7%). As expected, the incidence of fractures is higher in walking subjects. In walking subjects (n = 128) logistic regression analysis showed falls [adjusted relative risk (RR) = 3.3; 95% confidence interval (CI) = 1.3-8.4] and age (adjusted RR = 1.7; 95% CI = 1.1-2.3) to be variables independently and significantly associated with fractures, after adjusting for baseline bone mineral density (BMD) and sex. Hip fractures were associated with age (RR = 1.6; 95% CI = 1.1-2.3), and non-hip fractures with falls (RR = 4.1; 95% CI = 1.3-13.4). The importance of low BMD as a risk factor for fractures is reduced in the institutionalized elderly. However, other fracture-site-specific risk factors exert a greater influence.
Istituto di Medicina e Chirurgia Geriatrica, Università di Torino, Italia.
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Visentin
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Ciravegna
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Uscello
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Molaschi
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Fabris
D000058:Accidental Falls / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology* / Q000503:physiopathology; D006620:Hip Fractures / Q000453:epidemiology; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010024:Osteoporosis / Q000453:epidemiology / Q000503:physiopathology; D011446:Prospective Studies; D012307:Risk Factors