School of Population Health, University of New South Wales, Sydney, Australia.
Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
Osteoporos Int. 2024 Sep;35(9):1573-1584. doi: 10.1007/s00198-024-07115-3. Epub 2024 May 28.
UNLABELLED: The effect of deprivation on total bone health status has not been well defined. We examined the relationship between socioeconomic deprivation and poor bone health and falls and we found a significant association. The finding could be beneficial for current public health strategies to minimise disparities in bone health. PURPOSE: Socioeconomic deprivation is associated with many illnesses including increased fracture incidence in older people. However, the effect of deprivation on total bone health status has not been well defined. To examine the relationship between socioeconomic deprivation and poor bone health and falls, we conducted a cross-sectional study using baseline measures from the United Kingdom (UK) Biobank cohort comprising 502,682 participants aged 40-69 years at recruitment during 2006-2010. METHOD: We examined four outcomes: 1) low bone mineral density/osteopenia, 2) fall in last year, 3) fracture in the last five years, and 4) fracture from a simple fall in the last five years. To measure socioeconomic deprivation, we used the Townsend index of the participant's residential postcode. RESULTS: At baseline, 29% of participants had low bone density (T-score of heel < -1 standard deviation), 20% reported a fall in the previous year, and 10% reported a fracture in the previous five years. Among participants experiencing a fracture, 60% reported the cause as a simple fall. In the multivariable logistic regression model after controlling for other covariates, the odds of a fall, fracture in the last five years, fractures from simple fall, and osteopenia were respectively 1.46 times (95% confidence interval [CI] 1.42-1.49), 1.26 times (95% CI 1.22-1.30), 1.31 times (95% CI 1.26-1.36) and 1.16 times (95% CI 1.13-1.19) higher for the most deprived compared with the least deprived quantile. CONCLUSION: Socioeconomic deprivation was significantly associated with poor bone health and falls. This research could be beneficial to minimise social disparities in bone health.
目的:社会经济贫困与许多疾病有关,包括老年人骨折发病率增加。然而,贫困对整体骨骼健康状况的影响尚未得到很好的定义。为了研究社会经济贫困与骨骼健康不良和跌倒之间的关系,我们使用英国生物银行队列的基线数据进行了一项横断面研究,该队列包括 2006 年至 2010 年期间招募的 502682 名年龄在 40-69 岁的参与者。
方法:我们检查了四个结果:1)低骨密度/骨质疏松症,2)去年跌倒,3)过去五年内骨折,以及 4)过去五年内因简单跌倒而骨折。为了测量社会经济贫困,我们使用了参与者居住邮政编码的汤森指数。
结果:在基线时,29%的参与者骨密度低(足跟 T 评分<-1 个标准差),20%报告去年跌倒,10%报告过去五年内骨折。在经历骨折的参与者中,60%报告的原因是简单跌倒。在控制其他协变量的多变量逻辑回归模型中,跌倒、过去五年内骨折、简单跌倒引起的骨折和骨质疏松症的几率分别为 1.46 倍(95%置信区间 [CI] 1.42-1.49)、1.26 倍(95% CI 1.22-1.30)、1.31 倍(95% CI 1.26-1.36)和 1.16 倍(95% CI 1.13-1.19),与最贫困的五分位数相比,最高贫困的五分位数更高。
结论:社会经济贫困与骨骼健康不良和跌倒显著相关。这项研究可能有助于减少骨骼健康方面的社会差异。
J Musculoskelet Neuronal Interact. 2020-9-1
Front Endocrinol (Lausanne). 2019-9-26
BMC Public Health. 2017-12-15