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老年人预先存在的残疾及其脆性髋部骨折的风险。

Pre-Existing Disability and Its Risk of Fragility Hip Fracture in Older Adults.

机构信息

Institute of Health and Environment, Seoul National University, Seoul 08826, Korea.

Red Cross College of Nursing, Chung-Ang University, Seoul 06974, Korea.

出版信息

Int J Environ Res Public Health. 2019 Apr 7;16(7):1237. doi: 10.3390/ijerph16071237.

Abstract

: 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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37ce/6480526/371883634871/ijerph-16-01237-g001.jpg

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