Gender-specific Hip Fracture Risk in Community-dwelling and Institutionalized Seniors Age 65 Years and Older

Overview

Journal Osteoporos Int

Specialties Endocrinology
Orthopedics

Date 2013 Oct 19

PMID 24136101

Citations 15

Authors

M Finsterwald

E Sidelnikov

E J Orav

B Dawson-Hughes

R Theiler

A Egli

A Platz

H P Simmen

C Meier

D Grob

S Beck

H B Stahelin

H A Bischoff-Ferrari

Affiliations

Soon will be listed here.

Abstract

Unlabelled: In this study of acute hip fracture patients, we show that hip fracture rates differ by gender between community-dwelling seniors and seniors residing in nursing homes. While women have a significantly higher rate of hip fracture among the community-dwelling seniors, men have a significantly higher rate among nursing home residents.

Introduction: Differences in gender-specific hip fracture risk between community-dwelling and institutionalized seniors have not been well established, and seasonality of hip fracture risk has been controversial.

Methods: We analyzed detailed data from 1,084 hip fracture patients age 65 years and older admitted to one large hospital center in Zurich, Switzerland. In a sensitivity analysis, we extend to de-personalized data from 1,265 hip fracture patients from the other two large hospital centers in Zurich within the same time frame (total n = 2,349). The denominators were person-times accumulated by the Zurich population in the corresponding age/gender/type of dwelling stratum in each calendar season for the period of the study.

Results: In the primary analysis of 1,084 hip fracture patients (mean age 85.1 years; 78% women): Among community-dwelling seniors, the risk of hip fracture was twofold higher among women compared with men (RR = 2.16; 95% CI, 1.74-2.69) independent of age, season, number of comorbidities, and cognitive function; among institutionalized seniors, the risk of hip fracture was 26% lower among women compared with men (RR = 0.77; 95% CI: 0.63-0.95) adjusting for the same confounders. In the sensitivity analysis of 2,349 hip fracture patients (mean age 85.0 years, 76% women), this pattern remained largely unchanged. There is no seasonal swing in hip fracture incidence.

Conclusion: We confirm for seniors living in the community that women have a higher risk of hip fracture than men. However, among institutionalized seniors, men are at higher risk for hip fracture.

Citing Articles

Sports injuries in patients over 70 years of age. Survey in a regional hospital in an Alpine tourist region : DKOU science slam 2024.

Engelmann J, Weber S, Conti M, Teuber H, Simmen H, Haupt S Orthopadie (Heidelb). 2025; .

PMID: 40056181 DOI: 10.1007/s00132-025-04635-6.

Effect Modification on Death by Age and Sex in Elderly Hip Fracture.

Jang S, Cha Y, Park N, Kim K, Choy W J Bone Metab. 2022; 29(4):235-243.

PMID: 36529866 PMC: 9760768. DOI: 10.11005/jbm.2022.29.4.235.

Incidence of hip fracture in underweight individuals: a nationwide population-based cohort study in Korea.

Han S, Park J, Jang H, Nah S, Boo J, Han K J Cachexia Sarcopenia Muscle. 2022; 13(5):2473-2479.

PMID: 35852000 PMC: 9530551. DOI: 10.1002/jcsm.13046.

Prognosis and institutionalization of frail community-dwelling older patients following a proximal femoral fracture: a multicenter retrospective cohort study.

Loggers S, Nijdam T, Folbert E, Hegeman J, van der Velde D, Verhofstad M Osteoporos Int. 2022; 33(7):1465-1475.

PMID: 35396653 PMC: 9187528. DOI: 10.1007/s00198-022-06394-y.

Patient-specific risk factors for adverse outcomes following geriatric proximal femur fractures.

Becker N, Hafner T, Pishnamaz M, Hildebrand F, Kobbe P Eur J Trauma Emerg Surg. 2022; 48(2):753-761.

PMID: 35325262 PMC: 9001566. DOI: 10.1007/s00068-022-01953-8.

References

Lau E, Gillespie B, Valenti L, OCONNELL D . The seasonality of hip fracture and its relationship with weather conditions in New South Wales. Aust J Public Health. 1995; 19(1):76-80. DOI: 10.1111/j.1753-6405.1995.tb00301.x. View

Douglas S, Bunyan A, Chiu K, Twaddle B, Maffulli N . Seasonal variation of hip fracture at three latitudes. Injury. 2000; 31(1):11-9. DOI: 10.1016/s0020-1383(99)00192-8. View

Butler M, Norton R, Cheng A, Campbell A . The risks of hip fracture in older people from private homes and institutions. Age Ageing. 1996; 25(5):381-5. DOI: 10.1093/ageing/25.5.381. View

Kannus P, Parkkari J, Sievanen H, Heinonen A, Vuori I, Jarvinen M . Epidemiology of hip fractures. Bone. 1996; 18(1 Suppl):57S-63S. DOI: 10.1016/8756-3282(95)00381-9. View

Bischoff-Ferrari H . Relevance of vitamin D in muscle health. Rev Endocr Metab Disord. 2011; 13(1):71-7. DOI: 10.1007/s11154-011-9200-6. View

Chevalley T, Guilley E, Herrmann F, Hoffmeyer P, Rapin C, Rizzoli R . Incidence of hip fracture over a 10-year period (1991-2000): reversal of a secular trend. Bone. 2007; 40(5):1284-9. DOI: 10.1016/j.bone.2006.12.063. View

Boockvar K, Halm E, Litke A, Silberzweig S, McLaughlin M, Penrod J . Hospital readmissions after hospital discharge for hip fracture: surgical and nonsurgical causes and effect on outcomes. J Am Geriatr Soc. 2003; 51(3):399-403. DOI: 10.1046/j.1532-5415.2003.51115.x. View

Jacobsen S, Sargent D, Atkinson E, OFallon W, Melton 3rd L . Population-based study of the contribution of weather to hip fracture seasonality. Am J Epidemiol. 1995; 141(1):79-83. DOI: 10.1093/oxfordjournals.aje.a117348. View

Graafmans W, Ooms M, Bezemer P, Bouter L, Lips P . Different risk profiles for hip fractures and distal forearm fractures: a prospective study. Osteoporos Int. 1996; 6(6):427-31. DOI: 10.1007/BF01629573. View

10.

Ralis Z . Epidemic of fractures during period of snow and ice. Br Med J (Clin Res Ed). 1981; 282(6264):603-5. PMC: 1504415. View

11.

Folstein M, Folstein S, McHugh P . "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12(3):189-98. DOI: 10.1016/0022-3956(75)90026-6. View

12.

Cumming R . Nursing home residence and risk of hip fracture. Am J Epidemiol. 1996; 143(12):1191-4. DOI: 10.1093/oxfordjournals.aje.a008706. View

13.

Lu-Yao G, Baron J, Barrett J, Fisher E . Treatment and survival among elderly Americans with hip fractures: a population-based study. Am J Public Health. 1994; 84(8):1287-91. PMC: 1615444. DOI: 10.2105/ajph.84.8.1287. View

14.

Ooms M, Vlasman P, Lips P, Nauta J, Bouter L, VALKENBURG H . The incidence of hip fractures in independent and institutionalized elderly people. Osteoporos Int. 1994; 4(1):6-10. DOI: 10.1007/BF02352254. View

15.

Tenias J, Estarlich M, Fuentes-Leonarte V, Iniguez C, Ballester F . Short-term relationship between meteorological variables and hip fractures: an analysis carried out in a health area of the Autonomous Region of Valencia, Spain (1996-2005). Bone. 2009; 45(4):794-8. DOI: 10.1016/j.bone.2009.06.022. View

16.

Guccione A, Felson D, Anderson J, Anthony J, Zhang Y, Wilson P . The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. Am J Public Health. 1994; 84(3):351-8. PMC: 1614827. DOI: 10.2105/ajph.84.3.351. View

17.

Center J, Nguyen T, Schneider D, Sambrook P, Eisman J . Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet. 1999; 353(9156):878-82. DOI: 10.1016/S0140-6736(98)09075-8. View

18.

Sugarman J, Connell F, Hansen A, Helgerson S, Jessup M, Lee H . Hip fracture incidence in nursing home residents and community-dwelling older people, Washington State, 1993-1995. J Am Geriatr Soc. 2002; 50(10):1638-43. DOI: 10.1046/j.1532-5415.2002.50454.x. View

19.

Cummings S, Kelsey J, Nevitt M, ODowd K . Epidemiology of osteoporosis and osteoporotic fractures. Epidemiol Rev. 1985; 7:178-208. DOI: 10.1093/oxfordjournals.epirev.a036281. View

20.

Brennan nee Saunders J, Johansen A, Butler J, Stone M, Richmond P, Jones S . Place of residence and risk of fracture in older people: a population-based study of over 65-year-olds in Cardiff. Osteoporos Int. 2003; 14(6):515-9. DOI: 10.1007/s00198-003-1404-5. View