Fracture incidence in nursing homes in Japan

Nakamura, Kazutoshi; Oyama, Mari; Takahashi, Shunsuke; Yoshizawa, Yoshiaki; Kobayashi, Ryosaku; Oshiki, Rieko; Saito, Toshiko; Tsuchiya, Yasuo

doi:10.1007/s00198-009-1015-x

Cited by 11 publications

(4 citation statements)

References 13 publications

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“…We observed a higher risk for female nursing home residents compared to males confirming numerous previous studies [ 7 , 8 , 27 , 28 , 29 ]. The IRR between women and men decreased with rising age consistent to previous studies [ 7 , 8 ].…”

Section: Discussionsupporting

confidence: 92%

Incidence Rates of and Mortality after Hip Fracture among German Nursing Home Residents

Jacobs

Zeeb

Hoffmann

2018

IJERPH

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Little is known about hip fracture rates and post-fracture mortality among nursing home residents. This retrospective cohort study examined incidence rates (IR) of and mortality after hip fracture in this population focusing on sex differences. A cohort of >127,000 residents ≥65 years, newly admitted to German nursing homes between 2010 and 2014 were used to calculate age-, sex-, care-need- and time after admission-specific IR. To determine mortality, the Kaplan-Meier-method was applied. Using Cox regression, we studied mortality and estimated time-dependent hazard ratios (HRs). For this purpose, to each person with a hip fracture, one resident without a hip fracture was matched by sex, age and care-need using risk-set sampling. 75% were women (mean age: 84.0 years). During 168,588 person-years (PY), 8537 residents with at least one hip fracture were observed. The IR for women and men were 52.9 and 42.5/1000 PY. For both sexes, IR increased with rising age and decreased with increasing care-level. IR were highest in the first months after admission and subsequently declined afterwards. The impact of hip fractures on mortality was time-dependent. Mortality of residents with hip fracture was highest in the first two months after fracture compared to those without (HR): 2.82; 95% CI 2.57–3.11) and after six months, no differences were found (HR: 1.10; 95% CI 0.98–1.22) Further research should always include analyses stratified by sex, age and time period after admission.

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Section: Discussionsupporting

confidence: 92%

Incidence Rates of and Mortality after Hip Fracture among German Nursing Home Residents

Jacobs

Zeeb

Hoffmann

2018

IJERPH

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“… 27 In addition to studies that have established the effects of age on fracture risk, 2 , 27 , 28 there are studies that claim it has no effect. 29 , 30 In our study, the number of vertebral fractures was demonstrated to be positively correlated with age in both groups. Comorbid conditions, such as hemiplegia and dementia in individuals of an advanced age, and the degree of independence in daily life activities, as well as height, weight, and BMI, are reported to be factors associated with falls and fractures.…”

Section: Discussionsupporting

confidence: 60%

Analysis of kyphosis, vertebral fracture and bone mineral density measurement in women living in nursing homes

Türk

Şahin

Küçükler

et al. 2018

SMJ

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Objectives:To analyze the relationship between vertebral fracture, degree of kyphosis, and BMD in women living in nursing homes.Methods:This cross-sectional study was carried out in the Department of Physical Medicine and Rehabilitation, Hitit University Hospital, Corum, Turkey, between January 2014 and January 2015. Of the 126 female patients who participated in the study, 48 lived in nursing homes (nursing-home-group [NHG]), 78 lived in non-nursing home settings (control-group [CG]). Vertebral fractures were evaluated via the semi-quantitative Genant method. Cases in which a Cobb angle measured 40 degrees or more resulted in a diagnosis of kyphosis.Results:The mean age of participants in the NHG was 77.2±7.6 years and 76.8±6.2 years in the CG (p>0.05). The kyphosis rate in the NHG was found to be higher at 52.1% compared to 27.7% for the CG (p<0.001). In the NHG, 68.7% had osteoporosis, 31.3% had osteopenia; in the CG, 55.2% had osteoporosis, 32% had osteopenia, 12.8% had normal values (p<0.05).The vertebral fracture rate was 37.5% in the NHG and 24.3% in the CG (p>0.05). The Cobb angle had correlation with the number of fractures in both groups (p<0.05).Conclusions:The osteoporosis and kyphosis rates of women living in NHG were higher than those of women living in CG. As kyphosis and the number of fractures are correlated, it is important to analyze kyphosis in women residing in NHG.

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“…in institutionalized elderly, insufficient supply of these three nutrients, in addition to the lack of sun exposure as far as vitamin D is concerned, amplifies the risk of fractures by increasing both bone loss rate and fall propensity (31)(32)(33)(34)(35). hip fracture incidence is particularly elevated in nursing home residents, as observed in several countries (36)(37)(38). We recently reported results of an open trial exploring whether consumption of vitamin D and calcium enriched soft plain cheese may modify bone turnover in a way expected to attenuate the rate of bone loss among institutionalized elderly women (25).…”

Section: Participants and Designmentioning

confidence: 98%

Nutritional approach for inhibiting bone resorption in institutionalized elderly women with vitamin D insufficiency and high prevalence of fracture

Bonjour

Benoit

Pourchaire

et al. 2011

The Journal of nutrition, health and aging

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abstract:Background: nutritional approach to the deterioration of bone integrity and increased fracture risk appears to be particularly appropriate in elderly women living in nursing homes. Objective: to investigate the beneficial effect of the consumption of soft plain cheese on bone resorption markers in institutionalized elderly women. Design: Prospective, randomized crossover controlled study. Setting: six French nursing homes or other institutions for elderly. Participants: institutionalized women ≥ 65 years old with low vitamin D status and calcium intake below 700 mg/day. Intervention: consumption of soft plain cheese made of semi-skimmed milk which was fortified by both vitamin D3 (+1.25µg/100g) and milk extracted ca, thus achieving a total ca content of 151 mg/100g as compared to about 118 mg/100g for standard fresh cheese. two servings were taken every day during the 6 weeks that preceded or followed a period of 6 weeks without soft plain cheese consumption. Measurements: the primary end point was the change in serum carboxy terminal cross-linked telopeptide of type i collagen (ctX) selected as a marker of bone resorption. Results: 29 women aged 73-94 yr were selected, 21 of them with mean age 87.2±6.1 years remained compliant. the intervention increased calcium and protein intakes by 51% (904±228 vs. 599±122 mg/d) and 33 % (74.2±17.1 vs. 55.6±12.7 g/d, mean±sD), respectively. the dietary intervention was associated with a statistically significant increase in serum levels of both 25ohD and iGF-i, while those of Pth, ctX and traP5b were significantly reduced. compliance was 93,4 %. the daily consumption of two servings of soft plain cheese was well accepted in terms of tastiness and appetite suited portion size. Conclusion: this randomized crossover controlled trial demonstrates that in elderly women living in nursing homes, the consumption of soft plain cheese increasing the supply of vitamin D, calcium and proteins, could reduce bone resorption and thereby reduce the risk of incidental fragility fractures in the long term.

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Fracture incidence in nursing homes in Japan

Abstract: Fracture incidence in institutionalized elderly people is generally higher but is not higher for all types of fractures than the general population. In addition, totally dependent persons had a much lower risk of hip fracture.

Cited by 11 publications

References 13 publications

Incidence Rates of and Mortality after Hip Fracture among German Nursing Home Residents

Incidence Rates of and Mortality after Hip Fracture among German Nursing Home Residents

Analysis of kyphosis, vertebral fracture and bone mineral density measurement in women living in nursing homes

Nutritional approach for inhibiting bone resorption in institutionalized elderly women with vitamin D insufficiency and high prevalence of fracture

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