Wyeth, a Pfizer Company-Epidemiology, Collegeville, PA, USA.
Age Ageing. 2011 Jan;40(1):49-54. doi: 10.1093/ageing/afq146. Epub 2010 Nov 18.
hip fractures result in a significant burden to the patient, their caregivers and the health care system. Patients with Alzheimer's disease (AD) have a higher incidence of hip fracture compared with other older people without AD, although it is not clear if AD is an independent risk factor for hip fracture.
a retrospective cohort study was conducted using anonymised electronic medical records from primary care practices in the United Kingdom. Proportional hazards regression modelling with adjustment for potential confounders was used to evaluate AD as an independent risk factor for predicting hip fractures.
the incidence of hip fracture among patients with and without AD was 17.4 (95% CI, 15.7-19.2) and 6.6 (95% CI, 5.8-7.6) per 1,000 person years, respectively. Patients with AD had a hazard that was 3.2 (95% CI, 2.4-4.2) times that of non-AD patients after controlling for potential confounders. AD patients who experienced a hip fracture also had an increased mortality rate compared with non-AD patients who experienced a hip fracture (hazard ratio = 1.5; 95% CI, 1.1-1.9).
patients with AD and their caregivers should be advised on how to prevent hip fractures and more attention should be given to AD patients who are undergoing rehabilitation following a hip fracture.
髋部骨折会给患者、他们的照顾者和医疗保健系统带来重大负担。患有阿尔茨海默病（AD）的患者髋部骨折的发生率高于其他没有 AD 的老年人，尽管尚不清楚 AD 是否是髋部骨折的独立危险因素。
使用英国初级保健实践的匿名电子病历进行了回顾性队列研究。采用调整潜在混杂因素的比例风险回归模型来评估 AD 是否为预测髋部骨折的独立危险因素。
AD 患者和非 AD 患者的髋部骨折发生率分别为 17.4（95%CI，15.7-19.2）和 6.6（95%CI，5.8-7.6）/1000人年。在控制了潜在混杂因素后，AD 患者的风险是无 AD 患者的 3.2 倍（95%CI，2.4-4.2）。经历髋部骨折的 AD 患者与经历髋部骨折的非 AD 患者相比，死亡率也更高（风险比=1.5；95%CI，1.1-1.9）。
应告知 AD 患者及其照顾者如何预防髋部骨折，并且应该更加关注经历髋部骨折后正在康复的 AD 患者。
