Summary

Fall prevention programs have shown inconclusive results concerning hip fracture reduction. We found that fallers with poor health, low societal participation, and use of psychotropics/painkillers had a threefold to fivefold increased hip fracture risk compared to non-fallers without these risk factors. This may help target fall prevention towards high-risk individuals.

Introduction

To investigate whether self-reported information on health, societal participation, and drug use in older people, easily obtainable by health care providers, contribute to predict future hip fracture beyond self-reported falls.

Methods

We used data from 3801 women and 6439 men aged 70–79 years participating in population-based studies in five counties in Norway 2000–2003. Height and weight were measured. Socioeconomic status, lifestyle, health status, and history of falling were self-reported through questionnaires. Falls last year were dichotomized into one or more versus no falls. Hip fractures were identified by linkage to hospital data with follow-up through 2013. Hazard ratios (HR) with 95% confidence intervals (95% CI) for hip fracture by combinations of risk factors with history of falling were estimated using Cox proportional hazards regression.

Results

More women (32.4%) than men (27.7%) reported one or more falls during the previous year, and 17.9% of women (n = 682) and 8.9% of men (n = 572) suffered a hip fracture during median 11.6 years of follow-up. Poor health, low societal participation, and use of psychotropics/analgesics among fallers were strong predictors of hip fracture. The presence of all three risk factors and history of falling was associated with HR 2.92 (95% CI 2.10–4.05) for hip fracture in women and HR 4.60 (95% CI 2.71–7.81) in men compared to non-fallers without these factors.

Conclusion

Our study indicates that self-assessment of health, information about activities outside home, and drug use among fallers far better identify high risk of hip fracture in older people than information about falls alone.

中文翻译：

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后来发生髋部骨折的跌倒者的特征：NOREPOS 研究

概括

跌倒预防计划在减少髋部骨折方面显示出不确定的结果。我们发现，与没有这些风险因素的非跌倒者相比，健康状况不佳、社会参与度低和使用精神药物/止痛药的跌倒者髋部骨折风险增加了三到五倍。这可能有助于针对高危人群进行跌倒预防。

介绍

调查自我报告的老年人健康、社会参与和药物使用信息是否有助于预测未来的髋部骨折，而不是自我报告的跌倒。

方法

我们使用了 2000-2003 年在挪威五个县参与基于人口研究的 70-79 岁的 3801 名女性和 6439 名男性的数据。测量了身高和体重。通过问卷自我报告社会经济状况、生活方式、健康状况和跌倒史。去年的跌倒分为一次或多次跌倒与没有跌倒。通过与 2013 年随访的医院数据相关联来确定髋部骨折。使用 Cox 比例风险回归估计通过组合风险因素和跌倒史的髋部骨折风险比 (HR) 和 95% 置信区间 (95% CI) .

结果

女性 (32.4%) 比男性 (27.7%) 多于男性 (27.7%) 在上一年报告一次或多次跌倒，17.9% 的女性 ( n  = 682) 和 8.9% 的男性 ( n  = 572) 在中位 11.6 年期间发生髋部骨折的跟进。健康状况不佳、社会参与度低以及跌倒者使用精神药物/镇痛剂是髋部骨折的强预测因素。与没有这些因素的非跌倒者相比，所有三个风险因素的存在和跌倒史与女性髋部骨折的 HR 2.92 (95% CI 2.10–4.05) 和男性的 HR 4.60 (95% CI 2.71–7.81) 相关.

结论

我们的研究表明，对健康的自我评估、关于家庭外活动的信息以及跌倒者的药物使用情况，比单独跌倒的信息更能识别老年人髋部骨折的高风险。