Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Huddinge, Sweden.
Academic Primary Health Care Centre, Stockholm, Sweden.
PLoS One. 2021 Mar 5;16(3):e0247924. doi: 10.1371/journal.pone.0247924. eCollection 2021.
Fragility fracture of the hip is associated with reduced functional status and mortality. Poor self-rated health (SRH) might be such an indicator. Our aim was to study if SRH was associated with hip fractures and all-cause mortality within the next 10 years in community-dwelling older women. A population-based sample of 350 women aged between 69 and 79 years (median 72.4) assessed their SRH by answering the question "How would you rate your health right now" by putting a mark on a visual-analogue scale (0-100 mm). Information on hip fracture and mortality over the next 10 years was retrieved from health care registers. The association between SRH and hip fracture and all-cause mortality was tested with a Cox proportional hazards regression model. SRH was divided into low, intermediate, and high (reference) assessed SRH. During the study, 40 hip fractures and 72 deaths occurred. The median value of SRH was 62 mm (IQR 50-81 mm). The age-adjusted hazard ratio (HR) for hip fracture was significantly higher in the group with low and intermediate SRH; HR: 3.17 (95% CI 1.25-8.01), and HR: 2.75 (95% CI 1.08-7.04), compared with high SRH. Adding bone mineral density (at the femoral neck) gave even greater risk. We did not find the hypothesized association between SRH and mortality. In our study, SRH indicated a higher risk of future hip fracture in older women. SRH might be a marker that could add information about the risk of hip fracture independently of bone mineral density.
髋部脆性骨折与功能状态下降和死亡率降低有关。自我评估健康状况差（SRH）可能就是这样一个指标。我们的目的是研究社区居住的老年女性的 SRH 是否与髋部骨折和未来 10 年内的全因死亡率相关。对 350 名年龄在 69 至 79 岁之间的（中位数为 72.4 岁）人群进行了一项基于人群的样本研究，通过在视觉模拟量表（0-100mm）上打勾来回答“您现在如何评价自己的健康状况”的问题来评估他们的 SRH。通过医疗保健登记册检索未来 10 年内髋部骨折和死亡率的信息。使用 Cox 比例风险回归模型测试 SRH 与髋部骨折和全因死亡率之间的关系。SRH 分为低、中、高（参考）评估的 SRH。在研究期间，发生了 40 例髋部骨折和 72 例死亡。SRH 的中位数为 62mm（IQR 50-81mm）。低和中 SRH 组的髋部骨折年龄调整风险比（HR）明显更高；HR：3.17（95%CI 1.25-8.01），HR：2.75（95%CI 1.08-7.04），与高 SRH 相比。添加股骨颈处的骨密度甚至会增加更大的风险。我们没有发现 SRH 与死亡率之间存在假设的关联。在我们的研究中，SRH 表明老年女性未来髋部骨折的风险更高。SRH 可能是一个独立于骨密度的可提供髋部骨折风险信息的标志物。
