title: Socioeconomic and living conditions are determinants of hip fracture incidence and age occurrence among community-dwelling elderly.
abstract: In this prospective, 10-year study in community-dwelling elderly aged 50 years and over, hip fracture incidence and accordingly age at hip fracture were inversely associated with the area-level income, independently of the geographical area. Age at hip fracture also depended of marital status but in a gender-specific way.
  
  
  OBJECTIVE
  The purpose of this study is to investigate the impact of socioeconomic and living conditions on hip fracture incidence and age occurrence among community-dwelling elderly.
  
  
  METHODS
  Between January 1991 and December 2000, 2,454 hip fractures were recorded in community-dwelling adults aged 50 years and over in the Geneva University Hospital, State of Geneva, Switzerland. Median annual household income by postal code of residence (referred to as area-level income) based on the 1990 Census was used as a measure of socioeconomic condition and was stratified into tertiles (< 53,170; 53,170-58,678; and ≥ 58,678 CHF). Hip fracture incidence and age occurrence were calculated according to area-level income categories and adjusted for confounding factors among community-dwelling elderly.
  
  
  RESULTS
  Independently of the geographical area (urban versus rural), community-dwelling persons residing in areas with the medium income category presented a lower hip fracture incidence [OR 0.91 (0.82-0.99), p = 0.049] compared to those from the lowest income category. Those in the highest income category had a hip fracture at a significant older age [+1.58 (0.55-2.61) year, p = 0.003] as compared to those in the lowest income category. Age at hip fracture also depended on marital status but in a gender-specific way, with married women fracturing earlier.
  
  
  CONCLUSIONS
  These results indicate that incidence and age occurrence of hip fracture are influenced by area-level income and living conditions among community-dwelling elderly. Prevention programs may be encouraged in priority in communities with low income.
authors.affiliation: Centre for Interdisciplinary Gerontology, University of Geneva, Geneva, Switzerland.
authors.forename: E
authors.initials: E
authors.lastname: Guilley
authors.forename: F
authors.initials: F
authors.lastname: Herrmann
authors.forename: C-H
authors.initials: CH
authors.lastname: Rapin
authors.forename: P
authors.initials: P
authors.lastname: Hoffmeyer
authors.forename: R
authors.initials: R
authors.lastname: Rizzoli
authors.forename: T
authors.initials: T
authors.lastname: Chevalley
mesh_terms: D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006620:Hip Fractures / Q000191:economics* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012111:Residence Characteristics; D012307:Risk Factors; D012423:Rural Health; D012959:Socioeconomic Factors; D013557:Switzerland / Q000453:epidemiology; D014504:Urban Health