Study identifies demographic and clinical factors related to fractures among older Americans
Most fracture incidence studies
have focused on hip fractures
among white women. A new study
examined fractures at the hip and
five other anatomical sites and
included more population
subgroups than prior studies. It
found that blacks had the lowest
fracture rates for all sites except
the ankle and tibia/fibula. Asian,
African, and Hispanic Americans
all had lower fracture rates than
white Americans for all fracture
sites. Hip and spine fracture rates
were highest in the South, with
other fracture rates being highest
in the Northeast, according to a
team of researchers from the
University of Alabama at
Birmingham.
Women experienced more
fractures of each type than men,
and older persons more fractures
than those who were younger. For
each type of fracture, there was an
inverse association with median
household income. During the 6-year period of the study, hip
fracture was the only type of
fracture to decrease and spine
fracture the only type of fracture to
increase. Fall-related conditions and
depressive illnesses were
associated with each type of
fracture; conditions treated with
glucocorticoids were weakly
associated with each type of
fracture and more strongly with
spine fractures; and diabetes was
associated with ankle and humerus
fractures. The study was based on
claims data for 1.7 million
Medicare beneficiaries from 2000
to 2005.
The researchers recommend that
targeted interventions addressing
the risk of specific fractures be
developed for Americans of lower
socioeconomic status, those
residing in the Southern United
States, those with depression,
diabetes, renal disease, cancer, and
conditions for which
glucocorticoids are prescribed, as
well as those who have sustained
previous fractures. This study was
supported in part by the Agency
for Healthcare Research and
Quality (HS16956).
See "Clinical and demographic
factors associated with fractures
among older Americans" by
Allison J. Taylor, Ph.D., Lisa C.
Gary, Ph.D., Tarun Arora, M.S.,
and others in Osteoporosis
International 22, pp. 1263-1274,
2011.
— MWS
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