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Senior Citizen Health & Medicine
Eleven Factors Can Predict Hip Fracture Risk for
Postmenopausal Women
Knowing 5-year fracture risk will permit patients and
physicians to make informed choices
 Nov. 27, 2007 Hip fractures are a devastating
injury for senior citizens and are often associated with a shortened
lifespan. A new model has been created, however, that can help older
women estimate their risk of a hip fracture over a five-year period and
guide them in making choices to avoid injury.
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This clinical model uses 11 factors, including age,
to asses the risk for postmenopausal women, according to the report in
the November 28 issue of Journal of the American Medical Association.
The estimated 329,000 hip fractures that occur
annually in the United States are associated with a high rate of illness
and death and high cost. Prevention of hip fracture is a high priority
for patients, physicians, and public health, according to background
information in the article.
John Robbins, M.D., of the University of California
at Davis School of Medicine, Sacramento, and colleagues evaluated
clinical risk factors for hip fracture in postmenopausal women to create
a predictive model for the 5-year risk of hip fracture.
The study included data on a total of 93,676 women
who participated in the observational component of the Womens Health
Initiative (WHI), a multiethnic study. Factors were identified that were
predictors of hip fracture, which were then validated using data on
68,132 women who participated in the clinical trial.
The model also was tested in a subset of 10,750
women who had undergone dual-energy x-ray absorptiometry scans (DXA; an
imaging technique) for bone mass density assessment, which is used to
predict risk of hip fracture.
During an average follow-up of 7.6 years, 1,132 hip
fractures were identified among women participating in the observational
study (annualized rate, 0.16 percent), while during an average follow-up
of 8.0 years, 791 hip fractures occurred among women participating in
the clinical trial (annualized rate, 0.14 percent).
Eleven factors were identified that were predictive
of hip fracture within 5 years. These factors are -
1. age,
2. self-reported health,
3. weight,
4. height,
5. race/ethnicity,
6. self-reported physical activity,
7. history of fracture after age 54 years,
8. parental hip fracture,
9. current smoking,
10. current corticosteroid use and
11. treated diabetes.
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NIHSeniorHealth Website Adds Information on
Preventing Falls
Each year 1.6 million seniors go to the emergency
room due to falls
October 17, 2006 - Each year, more than 1.6 million
older Americans go to the emergency room for fall-related injuries.
Among older adults, falls are the number one cause of fractures,
hospital admissions for trauma, loss of independence and injury-related
deaths, but falls are not an inevitable part of life, even as a person
gets older. Information about the risks of falling and what you can do
to prevent falls has just been added to NIHSeniorHealth.gov.
Read more...
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Incorporating these factors into a clinical
algorithm was useful to predict the 5 year risk of hip fracture among
postmenopausal women of various ethnic backgrounds.
Further studies are needed to define the clinical
implications of this algorithm and to confirm treatment benefits for
those delineated by the WHI risk classification to be an increased risk
for hip fracture. Ultimately, the decision of whom to further screen for
osteoporosis and whom to treat will need to be based on available
resources and major social and political judgments.
Knowing the 5-year risk of fracture will permit
patients and physicians to make informed choices when balancing making
lifestyle changes against undergoing medical interventions. Publication
of these results, along with the user-friendly tool for their
application, will permit others to rapidly test their utility.
"However, we believe 11 readily available clinical
variables offer a simple means of stratifying the 5-year risk of hip
fracture in postmenopausal women, the researchers conclude.
Learning More About Preventing Falls
Among Older Adults
Among people 65 years and older, falls are the
leading cause of injury deaths and the most common cause of nonfatal
injuries and hospital admissions for trauma. Each year in the United
States, nearly one third of older adults experience a fall.
In 2003, more than 13,700 people 65 years or
older died of fall-related injuries. Another 1.8 million were treated in
emergency departments for nonfatal injuries related to falls. The total
direct cost for falls among older adults in 2000 was about $19 billion.
Given the growing population of this age group, this cost is expected to
reach $43.8 billion by 2020.
To learn more about falls among older adults and
what can be done to prevent them, check out the materials that follow.
Fact Sheets
Falls Among Older Adults: An Overview
Provides an overview of the problem of falls among older adults in the
United States and a brief outline of prevention strategies.
Costs of Falls Among Older Adults
Discusses the direct costs associated with fatal and nonfatal falls
among older adults in the United States.
Hip Fractures Among Older Adults
Provides information about the occurrence, consequences, and costs of
hip fractures, which are common fall-related injuries.
Falls in Nursing Homes
Discusses falls and their prevention among nursing home residents.
CDC Fall Prevention Activities
Highlights CDC-sponsored projects aimed at preventing falls among older
adults.
Brochures
Two brochures, developed by CDC and redesigned in
partnership with the CDC Foundation and MetLife Foundation, provide
steps that older adults and those who care for them can take to reduce
the risk of falls and related injuries. Both are available in English,
Spanish, and Chinese.
What YOU Can Do to Prevent Falls
Highlights four personal strategies for preventing falls.
Check for Safety: A Home Fall Prevention Checklist for Older Adults
Lists things to check for and fix in the home to reduce the risk of
falls.
Posters
Four
posters were developed in partnership with the CDC Foundation and
MetLife Foundation. Each highlights one of four key strategies for
preventing falls among older adults. All are available in English,
Spanish, and Chinese.
Figures and Maps
Charts, tables, and maps depict statistics about fall-related deaths
and injuries. See trends in fall-related death and nonfatal injury rates
and compare death rates by sex and by state.
Websites About Older Adults and Falls
Looking for more information? Click on the links
below for other organizations working to prevent older adult falls.
American Association of Retired Persons - An organization for people
50 and older that provides information and education, advocacy, and
community services through a national network of local chapters and
experienced volunteers.
Gerontological Society of America - A multidisciplinary organization
dedicated to the scientific study of aging and to the translation and
dissemination of research for practice and policy.
Home Safety Council - A national nonprofit organization dedicated to
preventing home-related injuries.
National Council on Aging - An advocacy organization dedicated to
improving the health and independence of older persons and to increasing
their contributions to communities, society, and future generations.
National Institute on Aging - One of the National Institutes of
Health, the NIA promotes healthy aging by conducting and supporting
biomedical, social, and behavioral research and public education.
National Osteoporosis Foundation - A voluntary, nonprofit health
organization and resource for information about the causes, prevention,
and treatment of osteoporosis, a risk factor for fall-related fractures.
National Resource Center for Safe Aging The Center gathers and
shares information and resources on senior safety with public health
professionals, older adults, and their families.
U.S. Administration on Aging - The Administration works to raise
awareness among other federal agencies, organizations, groups, and the
public about both the contributions and needs of older Americans. It
also informs older people and their caregivers about the benefits and
services available to help them.
U.S. Consumer Product Safety Commission - The federal regulatory
agency that protects the public against unreasonable risks of injuries
and deaths from consumer products.
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