Osteoporosis International

, Volume 4, Issue 1, pp 6–10

The incidence of hip fractures in independent and institutionalized elderly people

  • M. E. Ooms
  • P. Vlasman
  • P. Lips
  • J. Nauta
  • L. M. Bouter
  • H. A. Valkenburg
Original Article

Abstract

The incidence density of hip fractures in the population of Amsterdam, aged 70 years and over, was studied according to the type of residence. In 1989, 655 patients were admitted to nine hospitals within Amsterdam for a hip fracture. Postal codes were used to classify the residence of the population and the hip fracture cases as independent, home for the elderly or nursing home. Stepwise logistic regression was used for data analysis. The risk of hip fracture increased with age and was 1.7 times higher for women than for men. In the age group 70–74 years the relative risk (RR) was 7.6 for those in homes for the elderly and 5.8 for those in nursing homes, when compared with the independent elderly. This RR was approximately 1 for those in homes for the elderly aged 85 years and over. However, in nursing homes the RR was still 2.8 in the age group 95+. We concluded that, despite protective measures against falls, the institutionalized elderly are at greater risk of hip fracture than the independent elderly of the same age and sex. This higher risk is especially apparent in the ‘younger’ age groups.

Keywords

Elderly people Hip fractures Osteoporosis Residence 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Boereboom FTJ, Groot RRM de, Raymakers JA, et al. The incidence of hip fractures in the Netherlands. Neth J Med 1991;38:51–8.PubMedGoogle Scholar
  2. 2.
    Gallagher JC, Melton LJ, Riggs BL, et al. Epidemiology of fractures of the proximal femur in Rochester, Minnesota. Clin Orthop Rel Res 1980;150:163–71.Google Scholar
  3. 3.
    Cummings SR, Black DM, Rubin SM. Lifetime risks of hip, Colles', or vertebral fracture and coronary heart disease among white postmenopausal women. Arch Intern Med 1989;149:2445–8.PubMedGoogle Scholar
  4. 4.
    Johnell O, Nilsson B, Obrant K, et al. Age and sex patterns of hip fracture: changes in 30 years. Acta Orthop Scand 1984;55:290–2.PubMedGoogle Scholar
  5. 5.
    Lewis A. Fracture of the neck of the femur: changing incidence. BMJ 1981;283-1217–9.PubMedGoogle Scholar
  6. 6.
    Rodriguez JG, Sattin RW, Waxweiler RJ. Incidence of hip fractures, United States 1970–83. Am J Prev Med 1989;5:173–81.Google Scholar
  7. 7.
    Nagant de Deuxchaisnes C, Devogelaer JP. Increase in the incidence of hip fractures and the ratio of trochanteric to cervical hip fractures in Belgium. Calcif Tissue Int 1988;42:201–3,PubMedGoogle Scholar
  8. 8.
    Miller CW. Survival and ambulation following hip fracture. J Bone Joint Surg Am 1978;60:930–3.PubMedGoogle Scholar
  9. 9.
    Lips P, Obrant K. The pathogenesis and treatment of hip fractures. Osteoporosis Int 1991;1:218–31.CrossRefGoogle Scholar
  10. 10.
    Lips P. Metabolic causes and prevention of hip fractures. PhD thesis, Free University, Rodopi Amsterdam, 1982.Google Scholar
  11. 11.
    Rudman IW, Rudman D. High rate of fractures for men in nursing homes. Am J Phys Med Rehab 1989;68:2–5.Google Scholar
  12. 12.
    Hui SI, Slemenda CW, Johnston CC. Baseline measurement of bone mass predicts fracture in white women. Ann Intern Med 1989;11:355–61.Google Scholar
  13. 13.
    Houben PPJ. Huisvesting van ouderen in Nederland in een veranderingsproces. In: Nies HLGR, Kroone ThJM, Baeyens JP, et al., editors. Handboek ouder worden. Deventer: Van Loghum Slaterus, 1989:III.D.3a.:1–26.Google Scholar
  14. 14.
    Molen T van der, Meyboom-de Jong B, Smith RJA. Seniors inside and outside the rest home. (In Dutch: Hoogbejaarden in en buiten het verzorgingshuis.) Huisarts Wet 1991;34:377–84.Google Scholar
  15. 15.
    Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among the elderly living in the community. N Engl J Med 1988;319:1701–7.PubMedGoogle Scholar
  16. 16.
    Lips P, Ooms ME, Schegget RM ter, et al. Prevention of hip fractures in the elderly by vitamin D supplementation. In: Christiansen C, Overgaard K, editors. Osteoporosis 1990. Copenhagen: Osteopress ApS 1990:1086–7.Google Scholar
  17. 17.
    Boereboom FTJ. Hip fractures: a public health problem. PhD thesis, University of Utrecht, 1991.Google Scholar
  18. 18.
    Nydegger V, Rizzoli R, Rapin CH, Vasey H, Bonjour JP. Epidemiology of fractures of the proximal femur in Geneva: incidence, clinical and social aspect. Osteoporosis Int 1991;2:42–7.CrossRefGoogle Scholar
  19. 19.
    Melton III LJ, Ilstrup DM, Beckenbaugh RD, Riggs BL. Hip fracture recurrence. Clin Orthop Rel Res 1982;167:131–8.Google Scholar
  20. 20.
    Anonymous. Age distribution per municipal, 1 January 1989. Mndstat Bevolk (CBS) 1989;11:47–55.Google Scholar
  21. 21.
    Anonymous. Age distribution per municipal, 1 January 1991. Mndstat Bevolk (CBS) 1991;10:27–35.Google Scholar

Copyright information

© European Foundation for Osteoporosis 1994

Authors and Affiliations

  • M. E. Ooms
    • 1
  • P. Vlasman
    • 1
  • P. Lips
    • 1
    • 2
  • J. Nauta
    • 1
    • 3
  • L. M. Bouter
    • 1
    • 3
  • H. A. Valkenburg
    • 1
  1. 1.Institute for Research in Extramural Medicine (EMGO-Institute)Vrije Universiteit, Medical FacultyAmsterdamThe Netherlands
  2. 2.Department of EndocrinologyFree University HospitalThe Netherlands
  3. 3.Department of Epidemiology and BiostatisticsVrije UniversiteitAmsterdamThe Netherlands

Personalised recommendations