The burden of fractures in Brazil: a population-based study.
BACKGROUND
The elderly population is growing fast worldwide, and therefore, investigation of health outcomes peculiar to these individuals is a public health priority nowadays. The decade between 2000 and 2010 is denominated as the Bone and Joint Decade, and researchers are encouraged to quantity the burden of musculo-skeletal disorders worldwide. This is particularly relevant to developing countries, where the burden of these diseases is not well known. This study aims to evaluate the prevalence of fractures (lifetime and previous year) and its association with socio-demographic variables and medical diagnosis of osteoporosis.


METHODS
Population-based cross-sectional study including a multiple-stage sample of individuals aged 20 years or more living in Pelotas, a southern Brazilian city. Both the lifetime prevalence of fractures and the proportion of fractures in the year prior to the interview were investigated. Sex, age, skin color, socioeconomic level, schooling level and medical diagnosis of osteoporosis were used as independent variables. After descriptive and crude analyses, a Poisson regression was carried out in order to provide prevalence ratios including adjustment for confounding.


RESULTS
The lifetime prevalence of fractures was 28.3%, and 2.3% of the individuals broke a bone in the year prior to the interview. Among men, most fractures were caused by sports practice and happened in leisure-time outside home. Among women, most fractures occurred inside home and were caused by falls. The lifetime prevalence of fractures was positively associated with male sex and white or mixed skin color. The prevalence of fractures in the year prior to the interview was greater among poor individuals and those with a medical diagnosis of osteoporosis. Among all fractures happened in older adults (60 years or more) in the 12 months prior to the interview, 83.3% were caused by falls.


CONCLUSIONS
Data of this investigation might help policy makers to reduce the burden of fractures, particularly among women and older adults, by stimulating prevention against household falls and osteoporosis. Special attention should be given to the poorest individuals, who have a greater likelihood of developing several negative health outcomes and presented a higher risk of fractures in the present study.
Siqueira
Fernando Vinholes
FV
Post-graduate Program in Epidemiology, Federal University of Pelotas, Brazil. fcvsiqueira@uol.com.br
Facchini
Luiz Augusto
LA
Hallal
Pedro Curi
PC
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors