Evaluation of the age-adjusted incidence of hip fractures between urban and rural areas: the difference is not related to the prevalence of institutions for the elderly

As many as 40% of hip fractures occur in institutions for the elderly. Several studies have demonstrated a higher age-adjusted incidence of hip fractures in urban areas compared with rural areas. To assess whether this difference could be due to a preferential location of institutions for the elderl...

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Published in:Osteoporosis international 2002-01, Vol.13 (2), p.113-118
Main Authors: Chevalley, T, Herrmann, F R, Delmi, M, Stern, R, Hoffmeyer, P, Rapin, C H, Rizzoli, R
Format: Article
Language:English
Subjects:
Age Distribution
Aged
Aged, 80 and over
Female
Hip Fractures - epidemiology
Hip Fractures - etiology
Homes for the Aged - statistics & numerical data
Homes for the Aged - supply & distribution
Humans
Incidence
Institutionalization - statistics & numerical data
Logistic Models
Male
Osteoporosis - complications
Rural Health - statistics & numerical data
Sex Distribution
Switzerland - epidemiology
Urban Health - statistics & numerical data
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container_start_page 113
container_title Osteoporosis international
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creator Chevalley, T
Herrmann, F R
Delmi, M
Stern, R
Hoffmeyer, P
Rapin, C H
Rizzoli, R
description As many as 40% of hip fractures occur in institutions for the elderly. Several studies have demonstrated a higher age-adjusted incidence of hip fractures in urban areas compared with rural areas. To assess whether this difference could be due to a preferential location of institutions for the elderly in urban areas, we compared the incidence of hip fractures over a 5-year period in urban versus rural areas, as defined according to the population density (urban > 15 inhabitants/ha2). We then determined the age-adjusted incidence of hip fractures in institutional-dwelling elderly and home-dwelling elderly. Hip fracture incidence was 100.0/100,000 (150.5 in women and 43.8 in men) in urban areas, and 71.0/100,000 (107.2 in women and 32.8 in men) in rural areas (p
doi_str_mv 10.1007/s001980200002
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Several studies have demonstrated a higher age-adjusted incidence of hip fractures in urban areas compared with rural areas. To assess whether this difference could be due to a preferential location of institutions for the elderly in urban areas, we compared the incidence of hip fractures over a 5-year period in urban versus rural areas, as defined according to the population density (urban &gt; 15 inhabitants/ha2). We then determined the age-adjusted incidence of hip fractures in institutional-dwelling elderly and home-dwelling elderly. Hip fracture incidence was 100.0/100,000 (150.5 in women and 43.8 in men) in urban areas, and 71.0/100,000 (107.2 in women and 32.8 in men) in rural areas (p&lt;0.001). When only those patients living in their own homes were analyzed, the incidence was 66.7/100000 (94.6 in women and 35.7 in men) in urban regions and 36.8/100,000 (49.6 in women and 23.4 in men) in rural areas (p&lt;0.001), a difference of even greater magnitude than when both home-dwelling and institutional-dwelling residents were considered together. In a logistic regression model including age class, gender, urban or rural areas and institutionalization for inhabitants 65 years of age and older, urban residents have a 31% significantly (p&lt;0.001) higher incidence of hip fracture compared with rural residents; women have a 79% significantly (p&lt;0.001) higher incidence of hip fracture compared with men; and institutional-dwelling elderly have a 351% significantly (p&lt;0.001) higher incidence of hip fracture compared with home-dwelling elderly. These results confirm the existence of a higher age-adjusted incidence of hip fractures in urban compared with rural areas. 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Several studies have demonstrated a higher age-adjusted incidence of hip fractures in urban areas compared with rural areas. To assess whether this difference could be due to a preferential location of institutions for the elderly in urban areas, we compared the incidence of hip fractures over a 5-year period in urban versus rural areas, as defined according to the population density (urban &gt; 15 inhabitants/ha2). We then determined the age-adjusted incidence of hip fractures in institutional-dwelling elderly and home-dwelling elderly. Hip fracture incidence was 100.0/100,000 (150.5 in women and 43.8 in men) in urban areas, and 71.0/100,000 (107.2 in women and 32.8 in men) in rural areas (p&lt;0.001). 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When only those patients living in their own homes were analyzed, the incidence was 66.7/100000 (94.6 in women and 35.7 in men) in urban regions and 36.8/100,000 (49.6 in women and 23.4 in men) in rural areas (p&lt;0.001), a difference of even greater magnitude than when both home-dwelling and institutional-dwelling residents were considered together. In a logistic regression model including age class, gender, urban or rural areas and institutionalization for inhabitants 65 years of age and older, urban residents have a 31% significantly (p&lt;0.001) higher incidence of hip fracture compared with rural residents; women have a 79% significantly (p&lt;0.001) higher incidence of hip fracture compared with men; and institutional-dwelling elderly have a 351% significantly (p&lt;0.001) higher incidence of hip fracture compared with home-dwelling elderly. These results confirm the existence of a higher age-adjusted incidence of hip fractures in urban compared with rural areas. 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subjects Age Distribution
Aged
Aged, 80 and over
Female
Hip Fractures - epidemiology
Hip Fractures - etiology
Homes for the Aged - statistics & numerical data
Homes for the Aged - supply & distribution
Humans
Incidence
Institutionalization - statistics & numerical data
Logistic Models
Male
Osteoporosis - complications
Rural Health - statistics & numerical data
Sex Distribution
Switzerland - epidemiology
Urban Health - statistics & numerical data
title Evaluation of the age-adjusted incidence of hip fractures between urban and rural areas: the difference is not related to the prevalence of institutions for the elderly
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