Study identifies demographic and clinical factors related to fractures among older Americans
Research Activities, July 2012, No. 383
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.