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Socioeconomic and living conditions are determinants of hip fracture incidence and age occurrence among community-dwelling elderly

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Abstract

Summary

In this prospective, 10-year study in community-dwelling elderly aged 50 years and over, hip fracture incidence and accordingly age at hip fracture were inversely associated with the area-level income, independently of the geographical area. Age at hip fracture also depended of marital status but in a gender-specific way.

Purpose

The purpose of this study is to investigate the impact of socioeconomic and living conditions on hip fracture incidence and age occurrence among community-dwelling elderly.

Method

Between January 1991 and December 2000, 2,454 hip fractures were recorded in community-dwelling adults aged 50 years and over in the Geneva University Hospital, State of Geneva, Switzerland. Median annual household income by postal code of residence (referred to as area-level income) based on the 1990 Census was used as a measure of socioeconomic condition and was stratified into tertiles (<53,170; 53,170–58,678; and ≥58,678 CHF). Hip fracture incidence and age occurrence were calculated according to area-level income categories and adjusted for confounding factors among community-dwelling elderly.

Results

Independently of the geographical area (urban versus rural), community-dwelling persons residing in areas with the medium income category presented a lower hip fracture incidence [OR 0.91 (0.82–0.99), p = 0.049] compared to those from the lowest income category. Those in the highest income category had a hip fracture at a significant older age [+1.58 (0.55–2.61) year, p = 0.003] as compared to those in the lowest income category. Age at hip fracture also depended on marital status but in a gender-specific way, with married women fracturing earlier.

Conclusions

These results indicate that incidence and age occurrence of hip fracture are influenced by area-level income and living conditions among community-dwelling elderly. Prevention programs may be encouraged in priority in communities with low income.

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Acknowledgments

We thank René Bourdilloud (University Hospital of Geneva) for extracting the data file from the hospital information system and Daniel Baccino (Center for Interdisciplinary Gerontology) for data management. We acknowledge the assistance of Sophie Mouchet, Janine Dubois, and Chiara D'Aiuto from the local State Statistical Office, for providing us with official population data and data on population in nursing homes.

Conflict of interest

None

Author information

Authors and Affiliations

  1. Centre for Interdisciplinary Gerontology, University of Geneva, Geneva, Switzerland

    E. Guilley & C.-H. Rapin

  2. Service of Bone Diseases, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Geneva, Switzerland

    F. Herrmann, R. Rizzoli & T. Chevalley

  3. Service of Orthopaedic Surgery, Department of Surgery, University Hospitals of Geneva, Geneva, Switzerland

    P. Hoffmeyer

  4. Division of Bone Diseases, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland

    T. Chevalley

Authors
  1. E. Guilley
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  2. F. Herrmann
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  3. C.-H. Rapin
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  4. P. Hoffmeyer
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  5. R. Rizzoli
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  6. T. Chevalley
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Corresponding author

Correspondence to T. Chevalley.

Additional information

This work is dedicated to Charles-Henri Rapin’s memory.

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Guilley, E., Herrmann, F., Rapin, CH. et al. Socioeconomic and living conditions are determinants of hip fracture incidence and age occurrence among community-dwelling elderly. Osteoporos Int 22, 647–653 (2011). https://doi.org/10.1007/s00198-010-1287-1

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  • DOI: https://doi.org/10.1007/s00198-010-1287-1

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