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Int J Environ Res Public Health. 2019 Apr 7;16(7). pii: E1237. doi: 10.3390/ijerph16071237.

Pre-Existing Disability and Its Risk of Fragility Hip Fracture in Older Adults.

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Institute of Health and Environment, Seoul National University, Seoul 08826, Korea.
Red Cross College of Nursing, Chung-Ang University, Seoul 06974, Korea.
Department of Social and Behavioral Sciences, Harvard T.H. CHAN School of Public Health, Boston, MA 02115, USA.
Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University Institute on Aging, Seoul 13620, Korea.


Background: Hip fracture is one of the significant public concerns in terms of long-term care in aging society. We aimed to investigate the risk for the incidence of hip fracture focusing on disability among older adults. Methods: This was a population-based retrospective cohort study, focusing on adults aged 65 years or over who were included in the Korean National Health Insurance Service⁻National Sample from 2004 to 2013 (N = 90,802). Hazard ratios with 95% confidence interval (CIs) were calculated using the Cox proportional hazards model according to disability adjusted for age, household income, underlying chronic diseases, and comorbidity index. Results: The incidence of hip fracture was higher among older adults with brain disability (6.3%) and mental disability (7.5%) than among those with other types of disability, as observed during the follow-up period. Risk of hip fracture was higher among those who were mildly to severely disabled (hazard ratio for severe disability = 1.59; 95% CI, 1.33⁻1.89; mild = 1.68; 95% CI, 1.49⁻1.88) compared to those who were not disabled. Older men with mental disabilities experienced an incidence of hip fracture that was almost five times higher (hazard ratio, 4.98; 95% CI, 1.86⁻13.31) versus those that were not disabled. Conclusions: Older adults with mental disabilities and brain disability should be closely monitored and assessed for risk of hip fracture.


comorbidity; disability; gender; hip fracture; severity

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