Osteoporosis International

, Volume 5, Issue 4, pp 239–246 | Cite as

Risk factors for hip fracture in a high incidence area: A case-control study from Oslo, Norway

  • H. E. Meyer
  • C. Henriksen
  • J. A. Falch
  • J. I. Pedersen
  • A. Tverdal
Original Article

Abstract

The aim of this population-based matched case-control study was to evaluate the effect of risk factors for hip fracture in Oslo, Norway, which has some of the highest incidence rates ever reported. The study population comprised all non-institutionalized persons 50 years or older living in the catchment area of two Oslo hospitals, and cases were 246 patients admitted for hip fracture during a 1-year period. The controls were randomly selected from the study population, matched 1:1 for age and sex. Hip fracture was associated with lean body stature, smoking, low grip strength and decreased levels of physical activity, and inversely with length of education. In addition, hip fracture was inversely related to indicators of total food intake (number of meals per day, frequency of dinners, and slices of bread per day). A relation between hip fracture and low vitamin D intake was also suggested, whereas no association with dietary calcium intake was found. Finally, increased risk of fracture was seen in persons reporting two or more hospital admissions in the previous 2 years, and in those reporting weight reduction due to poor appetite during the previous year. In conclusion, the risk factor pattern for hip fracture was much the same in the elderly population of Oslo as previously described in other populations with a lower incidence of fracture. This study also indicates a relation between hip fracture and low food intake.

Keywords

Case-control study Hip fracture Risk factors Undernutrition Vitamin D 

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References

  1. 1.
    Falch JA, Ilebekk A, Slungaard U. Epidemiology of hip fractures in Norway. Acta Orthop Scand 1985;56:12–6.PubMedGoogle Scholar
  2. 2.
    Falch JA, Kaastad TS, Bohler G, Espeland J, Sundsvold OJ. Secular increase and geographical differences in hip fracture incidence in Norway. Bone 1993;14:643–5.PubMedGoogle Scholar
  3. 3.
    Ray WA, Griffin MR, West R, Strand L, Melton LJ. Incidence of hip fracture in Saskatchewan, Canada, 1976–1985 Am J Epidemiol 1990;131:502–9.Google Scholar
  4. 4.
    Paganini Hill A, Chao A, Ross RK, Henderson BE. Exercise and other factors in the prevention of hip fracture: the Leisure World study. Epidemiology 1991;2:16–25.PubMedGoogle Scholar
  5. 5.
    Grisso JA, Kelsey JL, Strom BL, et al. Risk factors for falls as a cause of hip fracture in women: the Northeast Hip Fracture Study Group. N Engl J Med 1991;324:1326–31.PubMedGoogle Scholar
  6. 6.
    Cooper C, Barker DJ, Wickham C. Physical activity, muscle strength, and calcium intake in fracture of the proximal femur in Britain. BMJ 1988;297:1443–6.PubMedGoogle Scholar
  7. 7.
    Mowe M, Bohmer T, Kindt E. Reduced nutritional status in an elderly population (>70 y) is probable before disease and possibly contributes to the development of disease. Am J Clin Nutr 1994;59:317–24.PubMedGoogle Scholar
  8. 8.
    McWhirter JP, Pennington CR. Incidence and recognition of malnutrition in hospital. BMJ 1994;308:945–8.PubMedGoogle Scholar
  9. 9.
    Engedal K, Haugen P, Gilje K, Laake P. Efficacy of short mental tests in the detection of mental impairment in old age. Compr Gerontol [A] 1988;2:87–93.Google Scholar
  10. 10.
    National Nutrition Council. Utvikling i norsk kosthold. Oslo: National Nutrition Council, 1993.Google Scholar
  11. 11.
    Kelsey JL, O'Brien LA, Grisso JA, Hoffman S. Issues in carrying out epidemiologic research in the elderly. Am J Epidemiol 1989;130:857–66.PubMedGoogle Scholar
  12. 12.
    Greenland S, Thomas DC. On the need for the rare disease assumption in case-control studies. Am J Epidemiol 1982;116:547–53.PubMedGoogle Scholar
  13. 13.
    Breslow NE, Day NE. Statistical methods in cancer research, vol 1, The analysis of case-control studies. Lyon: International Agency for Research on Cancer, 1980.Google Scholar
  14. 14.
    Edelstein SL, Barrett-Connor E. Relation between body size and bone mineral density in elderly men and women. Am J Epidemiol 1993;138:160–9.PubMedGoogle Scholar
  15. 15.
    Greenspan SL, Myers ER, Maitland LA, Resnick NM, Hayes WC. Fall severity and bone mineral density as risk factors for hip fracture in ambulatory elderly. JAMA 1994;271:128–33.PubMedGoogle Scholar
  16. 16.
    Lauritzen JB, Petersen MM, Lund B. Effect of external hip protectors on hip fractures. Lancet 1993;341:11–3.PubMedGoogle Scholar
  17. 17.
    Delmi M, Rapin CH, Bengoa JM, Delmas PD, Vasey H, Bonjour JP. Dietary supplementation in elderly patients with fractured neck of the femur. Lancet 1990;335:1013–6.PubMedGoogle Scholar
  18. 18.
    Nguyen T, Sambrook P, Kelly P, et al. Prediction of osteoporotic fractures by postural instability and bone density. BMJ 1993;307:1111–5.PubMedGoogle Scholar
  19. 19.
    Nevitt MC, Cummings SR. Type of fall and risk of hip and wrist fractures: the study of osteoporotic fractures. The Study of Osteoporotic Fractures Research Group. J Am Geriatr Soc 1993;41:1226–34.PubMedGoogle Scholar
  20. 20.
    Falch JA, Mowe M, Bohmer T, Haug E. Serum levels of intact parathyroid hormone in elderly patients with hip fracture living at home. Acta Endocrinol (Copenh) 1992;126:10–2.PubMedGoogle Scholar
  21. 21.
    Holbrook TL, Barrett-Connor E, Wingard DL. Dietary calcium and risk of hip fracture: 14-year prospective population study. Lancet 1988;2:1046–9.PubMedGoogle Scholar
  22. 22.
    Heikinheimo RJ, Inkovaara JA, Harju EJ, et al. Annual injection of vitamin D and fractures of aged bones. Calcif Tissue Int 1992;51:105–10.PubMedGoogle Scholar
  23. 23.
    Chapuy MC, Arlot ME, Delmas PD, Meunier PJ. Effect of calcium and cholecalciferol treatment for three years on hip fractures in elderly women. BMJ 1994;308:1081–2.PubMedGoogle Scholar
  24. 24.
    Heaney RP. Nutritional factors in osteoporosis. Annu Rev Nutr 1993;13:287–316.PubMedGoogle Scholar
  25. 25.
    Lau E, Donnan S, Barker DJ, Cooper C. Physical activity and calcium intake in fracture of the proximal femur in Hong Kong. BMJ 1988;297:1441–3.PubMedGoogle Scholar
  26. 26.
    Wickham CA, Walsh K, Cooper C, Barker DJ, Margetts BM, Morris J, Bruce SA. Dietary calcium, physical activity, and risk of hip fracture: a prospective study. BMJ 1989;299:889–92.PubMedGoogle Scholar
  27. 27.
    Perez Cano R, Galan Galan F, Dilsen G. Risk factors for hip fracture in Spanish and Turkish women. Bone 1993;14 Suppl 1:S69–S72.PubMedGoogle Scholar
  28. 28.
    Lauritzen JB, Lund B. Risk of hip fracture after osteoporosis fractures: 451 women with fracture of lumbar spine, olecranon, knee or ankle. Acta Orthop Scand 1993;64:297–300.PubMedGoogle Scholar

Copyright information

© European Foundation for Osteoporosis 1995

Authors and Affiliations

  • H. E. Meyer
    • 3
  • C. Henriksen
    • 1
  • J. A. Falch
    • 2
  • J. I. Pedersen
    • 1
  • A. Tverdal
    • 3
  1. 1.Institute of Nutrition ResearchUniversity of OsloOsloNorway
  2. 2.Department of Internal MedicineAker HospitalOsloNorway
  3. 3.National Health Screening ServiceOsloNorway

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