Grahn Kronhed Ann-Charlotte, Blomberg Carina, Karlsson Nadine, Löfman Owe, Timpka Toomas, Möller Margareta
Vadstena Primary Health Care Center, Jungfruvägen 5, 592 32, Vadstena, Sweden.
Osteoporos Int. 2005 Jun;16(6):700-6. doi: 10.1007/s00198-004-1732-0. Epub 2004 Sep 30.
Associations between a 10-year community-based osteoporosis and fall prevention program and fracture incidence amongst middle-aged and elderly residents in an intervention community are studied, and comparisons are made with a control community. A health-education program was provided to all residents in the intervention community, which addressed dietary intake, physical activity, smoking habits and environmental risk factors for osteoporosis and falls. Both communities are small, semi-rural and situated in Ostergotland County in southern Sweden. The analysis is based on incidences of forearm fractures in the population 40 years of age or older, and hip fractures in the population 50 years of age or older. Data for three 5-year periods (pre-, early and late intervention) are accumulated and compared. In the intervention community, forearm fracture incidence decreased in women. There are also tendencies towards decreasing forearm fracture incidence in men, and towards decreasing trochanteric hip fracture incidences in women and in men in the late intervention period. No such changes in fracture incidences are found in the control community. Cervical hip fracture incidence did not change in the intervention and the control communities. Although the reported numbers of fractures are small (a total of 451 forearm and 357 hip fractures), the numbers are based on total community populations and thus represent a true difference. The decrease in forearm fracture incidence among women, and the tendency towards decreasing trochanteric hip fractures, in contrast to the absence of change in cervical hip fractures, might be mainly due to a more rapid effect of fall preventive measures than an increase in bone strength in the population. For the younger age groups an expected time lag between intervention and effect might invalidate the short follow-up period for outcome measurements. Thus, the effect of the 10-year intervention program on fracture incidence should be followed during an extended post-intervention period.
研究了一项为期10年的基于社区的骨质疏松症和跌倒预防计划与干预社区中老年居民骨折发生率之间的关联，并与对照社区进行了比较。向干预社区的所有居民提供了一项健康教育计划，内容涉及饮食摄入、身体活动、吸烟习惯以及骨质疏松症和跌倒的环境风险因素。两个社区规模较小，半乡村化，位于瑞典南部的东约特兰省。分析基于40岁及以上人群的前臂骨折发生率以及50岁及以上人群髋部骨折发生率。收集并比较了三个5年期间（干预前、早期和晚期）的数据。在干预社区，女性的前臂骨折发生率有所下降。男性的前臂骨折发生率也有下降趋势，在干预后期，女性和男性的转子间髋部骨折发生率均有下降趋势。对照社区未发现骨折发生率有此类变化。干预社区和对照社区的颈椎髋部骨折发生率均未改变。尽管报告的骨折数量较少（前臂骨折共451例，髋部骨折共357例），但这些数字基于社区总人口，因此代表了真实差异。与颈椎髋部骨折无变化形成对比的是，女性前臂骨折发生率的下降以及转子间髋部骨折的下降趋势，可能主要是由于预防跌倒措施的效果比人群骨强度增加的效果更快。对于较年轻的年龄组，干预与效果之间预期的时间滞后可能会使结果测量的短期随访期无效。因此，应在干预后的延长期间跟踪10年干预计划对骨折发生率的影响。
