Epidemiology of lifetime fracture prevalence in England: a population study of adults aged 55 years and over.
BACKGROUND
fractures remain a substantial public health problem but epidemiological studies using survey data are sparse. This study explores the association between lifetime fracture prevalence and socio-demographic factors, health behaviours and health conditions.


METHODS
fracture prevalence was calculated using a combined dataset of annual, nationally representative health surveys in England (2002-07) containing 24,725 adults aged 55 years and over. Odds of reporting any fracture was estimated separately for each gender using logistic regression.


RESULTS
fracture prevalence was higher in men than women (49 and 40%, respectively). In men, factors having a significant independent association with fracture included being a former regular smoker [odds ratios, OR: 1.18 (1.06-1.31)], having a limiting long-standing illness [OR: 1.47 (1.31-1.66)] and consuming >8 units of alcohol on the heaviest drinking day in the past week [OR: 1.65 (1.37-1.98)]. In women, significant factors included being separated/divorced [OR: 1.30 (1.10-1.55)], having a 12-item General Health Questionnaire (GHQ-12) score of 4+ [OR: 1.59 (1.27-2.00)], consuming >6 units of alcohol in the past week [OR: 2.07 (1.28-3.35)] and being obese [OR: 1.25 (1.03-1.51)].


CONCLUSIONS
a range of socio-demographic, health behaviour and health conditions, known to increase the risk of chronic disease and premature death, are also associated with fracture occurrence, probably involving the aetiological pathways of poor bone health and fall-related trauma.
Epidemiology and Public Health, University College London, London, UK.
Shaun
S
Scholes
Sukhmeet
S
Panesar
Nicola Jane
NJ
Shelton
Roger M
RM
Francis
Saqeb
S
Mirza
Jennifer S
JS
Mindell
Liam J
LJ
Donaldson
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology; D004739:England / Q000453:epidemiology; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis / Q000453:epidemiology*; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D016017:Odds Ratio; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013997:Time Factors
fracture sites; lifetime fracture prevalence; logistic regression; older people; respondent recall; risk factors