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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.

Author information

1
Institute of Health and Environment, Seoul National University, Seoul 08826, Korea. kimjayeun@gmail.com.
2
Red Cross College of Nursing, Chung-Ang University, Seoul 06974, Korea. sjang@cau.ac.kr.
3
Department of Social and Behavioral Sciences, Harvard T.H. CHAN School of Public Health, Boston, MA 02115, USA. sjang@cau.ac.kr.
4
Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University Institute on Aging, Seoul 13620, Korea. drlim1@snu.ac.kr.

Abstract

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.

KEYWORDS:

comorbidity; disability; gender; hip fracture; severity

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