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Gender-specific hip fracture risk in community-dwelling and institutionalized seniors age 65years and older

Finsterwald, M. ; Sidelnikov, E. ; Orav, E. ; Dawson-Hughes, B. ; Theiler, R. ; Egli, A. ; Platz, A. ; Simmen, H. ; Meier, C. ; Grob, D. ; Beck, S. ; Stähelin, H. ; Bischoff-Ferrari, H.

In: Osteoporosis International, 2014, vol. 25, no. 1, p. 167-176

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    Titre
    • Gender-specific hip fracture risk in community-dwelling and institutionalized seniors age 65years and older
    Auteur
    • Finsterwald, M.. Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland
    • Sidelnikov, E.. Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland
    • Orav, E.. Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA
    • Dawson-Hughes, B.. USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
    • Theiler, R.. Department of Rheumatology, Triemly City Hospital Zurich, Zurich, Switzerland
    • Egli, A.. Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland
    • Platz, A.. Department of Traumatology, Triemly City Hospital Zurich, Zurich, Switzerland
    • Simmen, H.. Department of Emergency Medicine and Traumatology, University Hospital Zurich, Zurich, Switzerland
    • Meier, C.. Department of Traumatology, City Hospital Waid, Zurich, Switzerland
    • Grob, D.. Acute Geriatric Care, City Hospital Waid, Zurich, Switzerland
    • Beck, S.. Acute Geriatric Care, City Hospital Waid, Zurich, Switzerland
    • Stähelin, H.. Department of Geriatrics, University Hospital Basel, Basel, Switzerland
    • Bischoff-Ferrari, H.. Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland
    Type de document
    • Postprint
    Langue
    • Inglese
    Publié dans
    • Osteoporosis International, 2014, vol. 25, no. 1, p. 167-176. Springer London
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:325192
    Summary
    Summary: In this study of acute hip fracture patients, we show that hip fracture rates differ by gender between community-dwelling seniors and seniors residing in nursing homes. While women have a significantly higher rate of hip fracture among the community-dwelling seniors, men have a significantly higher rate among nursing home residents. Introduction: Differences in gender-specific hip fracture risk between community-dwelling and institutionalized seniors have not been well established, and seasonality of hip fracture risk has been controversial. Methods: We analyzed detailed data from 1,084 hip fracture patients age 65years and older admitted to one large hospital center in Zurich, Switzerland. In a sensitivity analysis, we extend to de-personalized data from 1,265 hip fracture patients from the other two large hospital centers in Zurich within the same time frame (total n = 2,349). The denominators were person-times accumulated by the Zurich population in the corresponding age/gender/type of dwelling stratum in each calendar season for the period of the study. Results: In the primary analysis of 1,084 hip fracture patients (mean age 85.1years; 78% women): Among community-dwelling seniors, the risk of hip fracture was twofold higher among women compared with men (RR = 2.16; 95% CI, 1.74-2.69) independent of age, season, number of comorbidities, and cognitive function; among institutionalized seniors, the risk of hip fracture was 26% lower among women compared with men (RR = 0.77; 95% CI: 0.63-0.95) adjusting for the same confounders. In the sensitivity analysis of 2,349 hip fracture patients (mean age 85.0years, 76% women), this pattern remained largely unchanged. There is no seasonal swing in hip fracture incidence. Conclusion: We confirm for seniors living in the community that women have a higher risk of hip fracture than men. However, among institutionalized seniors, men are at higher risk for hip fracture.