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Prediction of Hip Fracture in Elderly Men and Women by Fall-related Factors

Prediction of Hip Fracture in Elderly Men and Women by Fall-related Factors. ND Nguyen, C Pongchaiyakul, JR Center, JA Eisman, TV Nguyen Bone and Mineral Research Program Garvan Institute of Medical Research. Background.

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Prediction of Hip Fracture in Elderly Men and Women by Fall-related Factors

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  1. Prediction of Hip Fracture in Elderly Men and Women by Fall-related Factors ND Nguyen, C Pongchaiyakul, JR Center, JA Eisman, TV Nguyen Bone and Mineral Research Program Garvan Institute of Medical Research

  2. Background • Various risk factors for hip fracture, including low bone mineral density (BMD), have been identified in women, the situation in men remained unknown. • Hip fracture is largely resulted from a fall. • It is not known whether fall-related factors (muscle strength, postural instability) predict hip fracture.

  3. Aims • To assess the predictiveness and association between fall-related factors and hip fracture in elderly men and women

  4. Study Design and Methods Study design Longitudinal population-based epidemiological study Setting Dubbo city, Australia Participants 960 women and 689 men aged 60+ (as at 1989) of Caucasian background

  5. Outcome measure Incidence of hip fracture: ascertained by X-ray report Risk factors • Femoral neck BMD: by DEXA • Postural sway: by sway-meter • Quadriceps strength: maximum isometric contraction

  6. A non-fracture case A hip fracture case Postural sway test by the swaymeter

  7. Data analysis • Incidence of hip fracture was expressed per 1000 person-years assuming a the Poisson distribution. • Cox’s proportional hazards model was used to estimate relative risk (RR) • Individual risk factors were dichotomized into presence or absence. A combined risk score was derived as the sum of all individual risk factors for each individual.

  8. Results Results • Duration of follow-up: 12 y (6, 13) • 115 (86 F, 29M) hip fractures were ascertained Incidence of hip fracture per 1000 person-yrs

  9. Table 1: Baseline characteristics of participants as at 1989 * mean ± SD; ‡ n (%); † median (Q1, Q3); a significant difference between hip fracture and no fracture at P<0.001 for both sexes

  10. Risk factors for hip fracture after adjustment for FNBMD and sex

  11. Incidence of hip fracture by FNBMD (T-scores) and number of risk factors

  12. Conclusions • Falls and fall-related factors were important predictors of hip fracture in women and men. • Individuals with multiple risk factors with or without low BMD had the highest risk of hip fracture. • Women and men had common risk factors for hip fracture.

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