Pre-Existing Disability and Its Risk of Fragility Hip Fracture in Older Adults

Abstract

Background: Hip fracture is one of the significant public concerns in terms of long-term care in aging society. We aimed to investigate the risk for the incidence of hip fracture focusing on disability among older adults. Methods: This was a population-based retrospective cohort study, focusing on adults aged 65 years or over who were included in the Korean National Health Insurance Service–National Sample from 2004 to 2013 (N = 90,802). Hazard ratios with 95% confidence interval (CIs) were calculated using the Cox proportional hazards model according to disability adjusted for age, household income, underlying chronic diseases, and comorbidity index. Results: The incidence of hip fracture was higher among older adults with brain disability (6.3%) and mental disability (7.5%) than among those with other types of disability, as observed during the follow-up period. Risk of hip fracture was higher among those who were mildly to severely disabled (hazard ratio for severe disability = 1.59; 95% CI, 1.33–1.89; mild = 1.68; 95% CI, 1.49–1.88) compared to those who were not disabled. Older men with mental disabilities experienced an incidence of hip fracture that was almost five times higher (hazard ratio, 4.98; 95% CI, 1.86–13.31) versus those that were not disabled. Conclusions: Older adults with mental disabilities and brain disability should be closely monitored and assessed for risk of hip fracture.

Brain Diseases and Fall-Related Surgery in Older Persons

“…It is known that age-related brain symptoms (encephalopathy, gait difficulty [Parkinsonism with/without sarcopenia] [1], and dementia/delirium [2]) increase the likelihood of fall-related surgery. In contrast, it is not known which types of brain disease underlie such symptoms most, although fall-related surgery is conducted in up to 51% of patients white matter disease (WMD, also called small-vessel disease, accounting for gait difficulty) [3][4][5], up to 55% of patients with Alzheimer's disease (AD, for dementia) [6,7], up to 60% of patients with dementia with Lewy bodies (DLB, for gait difficulty and dementia) [8,9], and up to 25.7% of patients with alcoholism (for gait difficulty and dementia) [10,11].…”

Fratura por fragilidade: fatores de risco em uma coorte retrospectiva

“…10 Hip fractures, in particular, are among the health conditions that frequently require prolonged health care in an aging society. 11 The Brazilian population is aging; it is estimated that by 2060, the percentage of people aged 65 years or more will increase from 9.2% to 25.5%. In other words, 1 in 4 Brazilians will be an older adult.…”