Risk group for hip fracture in elderly women identified by primary care questionnaire--clinical implications.
BACKGROUND
Every fourth Swedish woman suffers hip fracture during life-time. Several methods for fall and fracture prevention are known. In this study we identify women at high hip fracture risk in a primary care population, describing their needs for possible fracture prevention as well.


METHODS
Cross-sectional questionnaire study for self-assessment by randomly chosen elderly women (n=100) over 70 years of age in a Primary health Care district at 1998. Questionnaire was designed from previous validated study. Follow-up study after three years performed at 2001.


RESULTS
Response rate was 92% (n=92, mean age 78) and 90% (n=83) answered the main 40 questions. 30% had at least two of four major risk factors for hip fracture; age over 80 years, body weight below 60 kg, recent fall and previous fragility fracture. The recall ability for at least two of these four risk factors was 93% in follow-up study after three years (relative risk = 8.0 with 95% confidence interval 3.5 to 18). 34% of the women had experienced any fracture since the age of 50. Only 22% of the women with previous fragility fracture had any pharmacological treatment for osteoporosis. 26% had falls in the preceding 12 months, mainly at home. Needs for fracture prevention were found in 34% (27 women).


CONCLUSIONS
Age, weight, recent falls or previous fragility fracture were common and important clinical risk factors for hip fracture with good recall ability after three years. By using this questionnaire in a Primary health Care district we identified women at high fracture risk. Needs for fracture prevention were observed for one third.
Albertsson
Daniel
D
Department of Primary Health Care, Gothenburg University, Sweden. daniel.albertsson@ltkronoberg.se
Gause-Nilsson
Ingrid
I
Mellström
Dan
D
Eggertsen
Robert
R
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D012306:Risk; D011795:Surveys and Questionnaires