Skip to main content
Top

12-07-2016 | Osteoporosis | Book Chapter | Article

9. Fracture Epidemiology Among Individuals 75+

Author: Heike A. Bischoff-Ferrari, MD, DrPH

Publisher: Springer International Publishing

Abstract

Fractures contribute significantly to morbidity and mortality of older individuals. Approximately 75 % of all osteoporotic fractures occur among seniors age 65 and older [1], and 1 in 2 women and 1 in 5 men age 50 are expected to sustain a fracture in their remaining life time [2].
Literature
1.
Melton 3rd LJ, Crowson CS, O’Fallon WM. Fracture incidence in Olmsted County, Minnesota: comparison of urban with rural rates and changes in urban rates over time. Osteoporos Int. 1999;9:29–37.CrossRefPubMed
2.
Nguyen ND, Ahlborg HG, Center JR, Eisman JA, Nguyen TV. Residual lifetime risk of fractures in women and men. J Bone Miner Res. 2007;12:12.
3.
Magaziner J, Hawkes W, Hebel JR, et al. Recovery from hip fracture in eight areas of function. J Gerontol A Biol Sci Med Sci. 2000;55:M498–507.CrossRefPubMed
4.
Tinetti ME, Williams CS. Falls, injuries due to falls, and the risk of admission to a nursing home. N Engl J Med. 1997;337:1279–84.CrossRefPubMed
5.
Cummings SR, Kelsey JL, Nevitt MC, O’Dowd KJ. Epidemiology of osteoporosis and osteoporotic fractures. Epidemiol Rev. 1985;7:178–208.PubMed
6.
Bischoff-Ferrari HA, Dawson-Hughes B, Platz A, et al. Effect of high-dosage cholecalciferol and extended physiotherapy on complications after hip fracture: a randomized controlled trial. Arch Intern Med. 2010;170:813–20.CrossRefPubMed
7.
Heyes GJ, Tucker A, Marley D, Foster A. Predictors for readmission up to 1 year following hip fracture. Arch Trauma Res. 2015;4, e27123.PubMedPubMedCentral
8.
Bischoff HA, Solomon DH, Dawson-Hughes B. Repeat hip fractures in a population-based sample of medicare recipi- ents in the US: rates, timing and gender differences. J Bone Miner Res. 2001;16 Suppl 1:291.
9.
Birge SJ, Morrow-Howell N, Proctor EK. Hip fracture. Clin Geriatr Med. 1994;10:589–609.PubMed
10.
Cummings SR, Rubin SM, Black D. The future of hip fractures in the United States. Numbers, costs, and potential effects of postmenopausal estrogen. Clin Orthop Relat Res. 1990;(252):163–6.
11.
Cummings SR, Nevitt MC, Browner WS, et al. Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group. N Engl J Med. 1995;332:767–73.CrossRefPubMed
12.
Fatalities and injuries from falls among older adults--United States, 1993–2003 and 2001–2005. MMWR Morb Mortal Wkly Rep. 2006;55:1221–4.
13.
Bischoff-Ferrari HA. Fall prevention. Primer on the metabolic bone diseases and disorders of mineral metabolism. Clifford J Rosen (Editor-in-Chief), Roger Bouillon (Senior Associate Editor), Juliet E Compston (Senior Associate Editor), Vicki Rosen (Senior Associate Editor). 8th ed. 2013. p. 389.
14.
Pluijm SM, Smit JH, Tromp EA, et al. A risk profile for identifying community-dwelling elderly with a high risk of recurrent falling: results of a 3-year prospective study. Osteoporos Int. 2006;17:417–25. Epub 2006 Jan 17.CrossRefPubMed
15.
EC. European economy: Special Report n° 1/2006. European commission, directorate-general for economic and financial affairs. http://​ec.​europa.​eu/​economy_​finance/​publications/​publication423_​en.​pdf
16.
Eberstadt N, Groth H. Europe’s coming demographic challenge: unlocking the value of health. Washington, DC: American Enterprise Institute for Health Policy Research; 2007.
17.
Europe Co. Recent demographic developments in Europe 2005. Strasbourg: European population Committee of the Council of Europe; 2006.
18.
Eurostat. First demographic estimates for 2005: statistics in focus. http://​epp.​eurostat.​ec.​europa.​eu/​cache/​ITY_​OFFPUB/​KS-NK-06-001/​EN/​KS-NK-06-001-ENPDF. 2006.
19.
Lee RD. Global population aging and its economic consequences. Washington, DC: AEI Press; 2007.
20.
Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319:1701–7.CrossRefPubMed
21.
Tinetti ME, Doucette J, Claus E, Marottoli R. Risk factors for serious injury during falls by older persons in the community. J Am Geriatr Soc. 1995;43:1214–21.CrossRefPubMed
22.
Bischoff-Ferrari HA, Orav JE, Kanis JA, et al. Comparative performance of current definitions of sarcopenia against the prospective incidence of falls among community-dwelling seniors age 65 and older. Osteoporos Int. 2015;26:2793–802.CrossRefPubMed
23.
Center JR, Bliuc D, Nguyen TV, Eisman JA. Risk of subsequent fracture after low-trauma fracture in men and women. JAMA. 2007;297:387–94.CrossRefPubMed
24.
Tinetti ME, Williams CS. The effect of falls and fall injuries on functioning in community-dwelling older persons. J Gerontol A Biol Sci Med Sci. 1998;53:M112–9.CrossRefPubMed
25.
Englander F, Hodson TJ, Terregrossa RA. Economic dimensions of slip and fall injuries. J Forensic Sci. 1996;41:733–46.CrossRefPubMed
26.
Cummings SR, Nevitt MC. Non-skeletal determinants of fractures: the potential importance of the mechanics of falls. Study of Osteoporotic Fractures Research Group. Osteoporos Int. 1994;4 Suppl 1:67–70.CrossRefPubMed
27.
Nguyen ND, Frost SA, Center JR, Eisman JA, Nguyen TV. Development of a nomogram for individualizing hip fracture risk in men and women. Osteoporos Int. 2007;17:17.
28.
Nevitt MC, Cummings SR. Type of fall and risk of hip and wrist fractures: the study of osteoporotic fractures. The Study of Osteoporotic Fractures Research Group. J Am Geriatr Soc. 1993;41:1226–34.CrossRefPubMed
29.
Nevitt MC, Cummings SR. Type of fall and risk of hip and wrist fractures: the study of osteoporotic fractures. J Am Geriatr Soc. 1994;42:909.CrossRefPubMed
30.
Carter SE, Campbell EM, Sanson-Fisher RW, Gillespie WJ. Accidents in older people living at home: a community-based study assessing prevalence, type, location and injuries. Aust N Z J Public Health. 2000;24:633–6.CrossRefPubMed
31.
Campbell AJ, Borrie MJ, Spears GF, Jackson SL, Brown JS, Fitzgerald JL. Circumstances and consequences of falls experienced by a community population 70 years and over during a prospective study. Age Ageing. 1990;19:136–41.CrossRefPubMed
32.
O’Neill TW, Marsden D, Adams JE, Silman AJ. Risk factors, falls, and fracture of the distal forearm in Manchester, UK. J Epidemiol Community Health. 1996;50:288–92.CrossRefPubMedPubMedCentral
33.
Graafmans WC, Ooms ME, Bezemer PD, Bouter LM, Lips P. Different risk profiles for hip fractures and distal forearm fractures: a prospective study. Osteoporos Int. 1996;6:427–31.CrossRefPubMed
34.
Keegan TH, Kelsey JL, King AC, Quesenberry Jr CP, Sidney S. Characteristics of fallers who fracture at the foot, distal forearm, proximal humerus, pelvis, and shaft of the tibia/fibula compared with fallers who do not fracture. Am J Epidemiol. 2004;159:192–203.CrossRefPubMed
35.
Vellas BJ, Wayne SJ, Romero LJ, Baumgartner RN, Garry PJ. Fear of falling and restriction of mobility in elderly fallers. Age Ageing. 1997;26:189–93.CrossRefPubMed
36.
Arfken CL, Lach HW, Birge SJ, et al. The prevalence and correlates of fear of falling in elderly persons living in the community. The relationship between fear of falling, activities of daily living and quality of life among elderly individuals. Fear of falling and restriction of mobility in elderly fallers. Am J Public Health. 1994;84:565–70.CrossRefPubMedPubMedCentral
37.
Cummings SR, Nevitt MC, Kidd S. Forgetting falls. The limited accuracy of recall of falls in the elderly. J Am Geriatr Soc. 1988;36:613–6.CrossRefPubMed
38.
Lewis CE, Ewing SK, Taylor BC, et al. Predictors of non-spine fracture in elderly men: the MrOS study. J Bone Miner Res. 2007;22:211–9.CrossRefPubMed
39.
Stone KL, Ewing SK, Lui LY, et al. Self-reported sleep and nap habits and risk of falls and fractures in older women: the study of osteoporotic fractures. J Am Geriatr Soc. 2006;54:1177–83.CrossRefPubMed
40.
Bischoff-Ferrari HA. In three steps to unbreakable bones. IOF report World Osteoporosis Report 2011. 2011; http://​www.​iofbonehealth.​org/​sites/​default/​files/​PDFs/​WODReports/​WOD11_​Report.​pdf.
41.
Barrett JA, Baron JA, Karagas MR, Beach ML. Fracture risk in the U.S. Medicare population. J Clin Epidemiol. 1999;52:243–9.CrossRefPubMed
42.
Cooper C, Melton 3rd LJ. Epidemiology of osteoporosis. Trends Endocrinol Metab. 1992;314:224–9.CrossRef
43.
Gullberg B, Johnell O, Kanis JA. World-wide projections for hip fracture. Osteoporos Int. 1997;7:407–13.CrossRefPubMed
44.
Kanis JA, Johnell O, De Laet C, Jonsson B, Oden A, Ogelsby AK. International variations in hip fracture probabilities: implications for risk assessment. J Bone Miner Res. 2002;17:1237–44.CrossRefPubMed
45.
Finsterwald M, Sidelnikov E, Orav EJ, et al. Gender-specific hip fracture risk in community-dwelling and institutionalized seniors age 65 years and older. Osteoporos Int. 2014;25:167–76.CrossRefPubMed
46.
Looker AC, Harris TB, Madans JH, Sempos CT. Dietary calcium and hip fracture risk: the NHANES I Epidemiologic Follow-Up Study. Osteoporos Int. 1993;3:177–84.CrossRefPubMed
47.
Samelson EJ, Zhang Y, Kiel DP, Hannan MT, Felson DT. Effect of birth cohort on risk of hip fracture: age-specific incidence rates in the Framingham Study. Am J Public Health. 2002;92:858–62.CrossRefPubMedPubMedCentral
48.
Chang KP, Center JR, Nguyen TV, Eisman JA. Incidence of hip and other osteoporotic fractures in elderly men and women: Dubbo Osteoporosis Epidemiology Study. J Bone Miner Res. 2004;19:532–6.CrossRefPubMed
49.
Cummings SR, San Martin J, McClung MR, et al. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med. 2009;361:756–65.CrossRefPubMed
50.
Black DM, Delmas PD, Eastell R, et al. Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med. 2007;356:1809–22.CrossRefPubMed
51.
McClung MR, Geusens P, Miller PD, et al. Effect of risedronate on the risk of hip fracture in elderly women. Hip Intervention Program Study Group. N Engl J Med. 2001;344:333–40.CrossRefPubMed
52.
Cummings SR, Black DM, Thompson DE, et al. Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial. JAMA. 1998;280:2077–82.CrossRefPubMed
53.
Lips P, Graafmans WC, Ooms ME, Bezemer PD, Bouter LM. Vitamin D supplementation and fracture incidence in elderly persons. A randomized, placebo-controlled clinical trial. Ann Intern Med. 1996;124:400–6.CrossRefPubMed
54.
Chapuy MC, Arlot ME, Duboeuf F, et al. Vitamin D3 and calcium to prevent hip fractures in the elderly women. N Engl J Med. 1992;327:1637–42.CrossRefPubMed
55.
Chapuy MC, Pamphile R, Paris E, et al. Combined calcium and vitamin D3 supplementation in elderly women: confirmation of reversal of secondary hyperparathyroidism and hip fracture risk: the Decalyos II study. Osteoporos Int. 2002;13:257–64.CrossRefPubMed
56.
Bischoff-Ferrari HA, Dawson-Hughes B, Willett CW, et al. Effect of vitamin D on falls: a meta-analysis. JAMA. 2004;291:1999–2006.CrossRefPubMed
57.
Trivedi DP, Doll R, Khaw KT. Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial. BMJ. 2003;326:469.CrossRefPubMedPubMedCentral
58.
Bischoff-Ferrari HA, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson-Hughes B. Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA. 2005;293:2257–64.CrossRefPubMed
59.
Johnell O, Borgstrom F, Jonsson B, Kanis J. Latitude, socioeconomic prosperity, mobile phones and hip fracture risk. Osteoporos Int. 2007;18:333–7.CrossRefPubMed
60.
Nevitt MC, Cummings SR, Stone KL, et al. Risk factors for a first-incident radiographic vertebral fracture in women > or = 65 years of age: the study of osteoporotic fractures. J Bone Miner Res. 2005;20:131–40.CrossRefPubMed
61.
Amin S, Zhang Y, Felson DT, et al. Estradiol, testosterone, and the risk for hip fractures in elderly men from the Framingham Study. Am J Med. 2006;119:426–33.CrossRefPubMed
62.
Bischoff-Ferrari HA, Orav JE, Barrett JA, Baron JA. Effect of seasonality and weather on fracture risk in individuals 65 years and older. Osteoporos Int. 2007;18:1225–33.CrossRefPubMed
63.
Nevitt MC, Ettinger B, Black DM, et al. The association of radiographically detected vertebral fractures with back pain and function: a prospective study. Ann Intern Med. 1998;128:793–800.CrossRefPubMed
64.
Silverman SL, Minshall ME, Shen W, Harper KD, Xie S. The relationship of health-related quality of life to prevalent and incident vertebral fractures in postmenopausal women with osteoporosis: results from the Multiple Outcomes of Raloxifene Evaluation Study. Arthritis Rheum. 2001;44:2611–9.CrossRefPubMed
65.
Lindsay R, Silverman SL, Cooper C, et al. Risk of new vertebral fracture in the year following a fracture. JAMA. 2001;285:320–3.CrossRefPubMed
66.
Hasserius R, Karlsson MK, Jonsson B, Redlund-Johnell I, Johnell O. Long-term morbidity and mortality after a clinically diagnosed vertebral fracture in the elderly--a 12- and 22-year follow-up of 257 patients. Calcif Tissue Int. 2005;76:235–42.CrossRefPubMed
67.
Praemer A, Furner S, Rice DP. Musculoskeletal conditions in the United States. Rosemont: American Academy of Orthopedic Surgeons; 1992. p. 145–70.
68.
O’Neill TW, Felsenberg D, Varlow J, Cooper C, Kanis JA, Silman AJ. The prevalence of vertebral deformity in European men and women: the European Vertebral Osteoporosis Study. J Bone Miner Res. 1996;11:1010–8.CrossRefPubMed
69.
Melton 3rd LJ, Lane AW, Cooper C, Eastell R, O’Fallon WM, Riggs BL. Prevalence and incidence of vertebral deformities. Osteoporos Int. 1993;3:113–9.CrossRefPubMed
70.
Johnell O, Kanis JA, Oden A, et al. Mortality after osteoporotic fractures. Osteoporos Int. 2004;15:38–42.CrossRefPubMed
71.
Melton 3rd LJ, Achenbach SJ, Atkinson EJ, Therneau TM, Amin S. Long-term mortality following fractures at different skeletal sites: a population-based cohort study. Osteoporos Int. 2013;24:1689–96.CrossRefPubMed
72.
Melton 3rd LJ, Therneau TM, Larson DR. Long-term trends in hip fracture prevalence: the influence of hip fracture incidence and survival. Osteoporos Int. 1998;8:68–74.CrossRefPubMed
73.
Myers AH, Robinson EG, Van Natta ML, Michelson JD, Collins K, Baker SP. Hip fractures among the elderly: factors associated with in-hospital mortality. Am J Epidemiol. 1991;134:1128–37.PubMed
74.
Wehren LE, Hawkes WG, Orwig DL, Hebel JR, Zimmerman SI, Magaziner J. Gender differences in mortality after hip fracture: the role of infection. J Bone Miner Res. 2003;18:2231–7.CrossRefPubMed
75.
Lyons AR. Clinical outcomes and treatment of hip fractures. Am J Med. 1997;103:51S–63; discussion S-4S.CrossRefPubMed
76.
Browner WS, Pressman AR, Nevitt MC, Cummings SR. Mortality following fractures in older women. The study of osteoporotic fractures. Arch Intern Med. 1996;156:1521–5.CrossRefPubMed
77.
Douglas AS, Allan TM, Rawles JM. Composition of seasonality of disease. Scott Med J. 1991;36:76–82.PubMed
78.
Wilkinson P, Pattenden S, Armstrong B, et al. Vulnerability to winter mortality in elderly people in Britain: population based study. BMJ. 2004;17:17.
79.
Wilkinson P, Pattenden S, Armstrong B, et al. Vulnerability to winter mortality in elderly people in Britain: population based study. BMJ. 2004;329:647. Epub 2004 Aug 17.CrossRefPubMedPubMedCentral
80.
Lieberman D, Friger MD. Seasonal variation in hospital admissions for community-acquired pneumonia: a 5-year study. J Infect. 1999;39:134–40.CrossRefPubMed
81.
Vilkman S, Keistinen T, Tuuponen T, Kivela SL. Seasonal variation in hospital admissions for chronic obstructive pulmonary disease in Finland. Arctic Med Res. 1996;55:182–6.PubMed
82.
Spencer FA, Goldberg RJ, Becker RC, Gore JM. Seasonal distribution of acute myocardial infarction in the second National Registry of Myocardial Infarction. J Am Coll Cardiol. 1998;31:1226–33.CrossRefPubMed
83.
Jacobsen SJ, Sargent DJ, Atkinson EJ, O’Fallon WM, Melton 3rd LJ. Population-based study of the contribution of weather to hip fracture seasonality. Am J Epidemiol. 1995;141:79–83.PubMed
84.
Bulajic-Kopjar M. Seasonal variations in incidence of fractures among elderly people. Inj Prev. 2000;6:16–9.CrossRefPubMedPubMedCentral
85.
Hemenway D, Colditz GA. The effect of climate on fractures and deaths due to falls among white women. Accid Anal Prev. 1990;22:59–65.CrossRefPubMed
86.
Jacobsen SJ, Goldberg J, Miles TP, Brody JA, Stiers W, Rimm AA. Seasonal variation in the incidence of hip fracture among white persons aged 65 years and older in the United States, 1984–1987. Am J Epidemiol. 1991;133:996–1004.PubMed
87.
Lau EM, Gillespie BG, Valenti L, O’Connell D. The seasonality of hip fracture and its relationship with weather conditions in New South Wales. Aust J Public Health. 1995;19:76–80.CrossRefPubMed
88.
Mannius S, Mellstrom D, Oden A, Rundgren A, Zetterberg C. Incidence of hip fracture in western Sweden 1974–1982. Comparison of rural and urban populations. Acta Orthop Scand. 1987;58:38–42.CrossRefPubMed
89.
Zetterberg C, Andersson GB. Fractures of the proximal end of the femur in Goteborg, Sweden, 1940–1979. Acta Orthop Scand. 1982;53:419–26.CrossRefPubMed
90.
Jacobsen SJ, Sargent DJ, Atkinson EJ, O’Fallon WM, Melton 3rd LJ. Contribution of weather to the seasonality of distal forearm fractures: a population-based study in Rochester, Minnesota. Osteoporos Int. 1999;9:254–9.CrossRefPubMed
91.
Ralis ZA. Epidemic of fractures during period of snow and ice. Br Med J (Clin Res Ed). 1981;282:603–5.CrossRef
92.
Bischoff-Ferrari HA, Orav JE, Barrett JA, Baron JA. Effect of seasonality and weather on fracture risk in individuals 65 years and older. Osteoporos Int. 2007;24:24.
93.
Holick MF. The photobiology of vitamin D and its consequences for humans. Ann N Y Acad Sci. 1985;453:1–13.CrossRefPubMed
94.
Harris SS, Dawson-Hughes B. Seasonal changes in plasma 25-hydroxyvitamin D concentrations of young American black and white women. Am J Clin Nutr. 1998;67:1232–6.PubMed
95.
Dawson-Hughes B, Harris SS, Krall EA, Dallal GE. Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med. 1997;337:670–6.CrossRefPubMed
96.
Bischoff-Ferrari HA, Zhang Y, Kiel DP, Felson DT. Positive association between serum 25-hydroxyvitamin D level and bone density in osteoarthritis. Arthritis Rheum. 2005;53:821–6.CrossRefPubMed
97.
Karagas MR, Baron JA, Barrett JA, Jacobsen SJ. Patterns of fracture among the United States elderly: geographic and fluoride effects. Ann Epidemiol. 1996;6:209–16.CrossRefPubMed
98.
van Geel TA, van Helden S, Geusens PP, Winkens B, Dinant GJ. Clinical subsequent fractures cluster in time after first fractures. Ann Rheum Dis. 2009;68:99–102.CrossRefPubMed
99.
van Geel TA, Huntjens KM, van den Bergh JP, Dinant GJ, Geusens PP. Timing of subsequent fractures after an initial fracture. Curr Osteoporos Rep. 2010;8:118–22.CrossRefPubMedPubMedCentral