Institute of Health and Environment, Seoul National University, Seoul 08826, Korea.
Red Cross College of Nursing, Chung-Ang University, Seoul 06974, Korea.
Int J Environ Res Public Health. 2019 Apr 7;16(7):1237. doi: 10.3390/ijerph16071237.
: 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. : 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 ( = 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. : 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. : Older adults with mental disabilities and brain disability should be closely monitored and assessed for risk of hip fracture.
髋部骨折是老龄化社会长期护理的重大公共问题之一。我们旨在研究关注老年人残疾的髋部骨折发病率的风险。
这是一项基于人群的回顾性队列研究，研究对象为 2004 年至 2013 年期间参加韩国国家健康保险服务-国家样本的年龄在 65 岁及以上的成年人（n=90802）。使用 Cox 比例风险模型，根据残疾调整后的年龄、家庭收入、潜在慢性疾病和合并症指数，计算出风险比及其 95%置信区间（CI）。
在随访期间，与其他类型的残疾相比，有脑残疾（6.3%）和精神残疾（7.5%）的老年人髋部骨折发生率更高。与无残疾者相比，轻度至重度残疾者（严重残疾风险比=1.59；95%CI，1.33⁻1.89；轻度残疾=1.68；95%CI，1.49⁻1.88）发生髋部骨折的风险更高。与无残疾者相比，有精神残疾的老年男性髋部骨折的发病率几乎高出五倍（风险比，4.98；95%CI，1.86⁻13.31）。
有精神残疾和脑残疾的老年人应密切监测和评估髋部骨折的风险。
