Department of Community Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata, Japan.
Osteoporos Int. 2010 May;21(5):797-803. doi: 10.1007/s00198-009-1015-x. Epub 2009 Jul 18.
We conducted the first study to determine fracture incidence in institutionalized elderly people in East Asia. Fracture incidence was generally higher than in the general population but was not for all fracture types. Specific fracture prevention strategies for institutionalized people are needed. Ethnic differences in fracture incidence are also discussed.
The aim of this study was to determine the incidence of fractures in nursing homes in Japan, where fracture is becoming an increasingly problematic health issue.
We conducted a cohort study with a 1-year follow-up. Subjects were 8,905 residents (average age, 84.3 years) in nursing homes. Caregivers assessed activities of daily living levels using Barthel's index, and we collected demographic data of each resident. Fracture diagnosis was based on medical records from the hospitals where patients were admitted.
Incidence of hip fracture was 14.9 per 1,000 person-years for women and 9.7 for men. Incidence of forearm and upper-arm fractures was 1.9 and 5.1 for women and 0.5 and 2.1 for men, respectively. Hip and upper-arm fracture rates were higher than in the general population, but forearm fracture rates were lower. Hazard ratio of fracture incidence in totally dependent to partially dependent or independent subjects was 0.14 (95%CI 0.05-0.33) for hip fracture and 0.34 (95%CI 0.23-0.50) for all fractures.
Fracture incidence in institutionalized elderly people is generally higher but is not higher for all types of fractures than the general population. In addition, totally dependent persons had a much lower risk of hip fracture.
本研究旨在确定日本养老院中骨折的发生率，因为骨折在日本已成为一个日益严重的健康问题。
我们进行了一项队列研究，随访时间为 1 年。研究对象为养老院的 8905 名居民（平均年龄 84.3 岁）。护理人员使用巴氏量表评估日常生活活动能力，收集每位居民的人口统计学数据。骨折的诊断基于患者入院的医院病历。
女性髋部骨折的发生率为每 1000 人年 14.9 例，男性为 9.7 例。女性前臂和上臂骨折的发生率分别为 1.9 和 5.1，男性分别为 0.5 和 2.1。髋部和上臂骨折的发生率高于普通人群，但前臂骨折的发生率较低。完全依赖者髋部骨折的发生率是部分依赖或独立者的 0.14（95%CI 0.05-0.33），所有骨折的发生率是 0.34（95%CI 0.23-0.50）。
与普通人群相比，养老院中老年人的骨折发生率普遍较高，但并非所有类型的骨折发生率都较高。此外，完全依赖者髋部骨折的风险要低得多。
