Aoyagi K, Ross P D, Davis J W, Wasnich R D, Hayashi T, Takemoto T
Department of Public Health, Nagasaki University, School of Medicine, Sakamoto, Japan.
J Bone Miner Res. 1998 Sep;13(9):1468-74. doi: 10.1359/jbmr.1998.13.9.1468.
Japanese have a lower incidence of hip fracture than Caucasians despite having lower bone mass. Hip fractures usually occur after a fall, and differing incidence rates of falls might explain the observed differences in hip fracture rates. To explore this hypothesis, we studied falls and related conditions among 1534 (624 men, 910 women) community-dwelling people aged 65 years and over in Japan and compared the prevalence of falls to Japanese-Americans living in Hawaii and to published studies of Caucasians. In Japan, 9% of the men and 19% of the women reported one or more falls during the past year. The prevalence of falls increased with age in both genders and was greater among women compared with men. In logistic regression models, having musculoskeletal disease, physical disability or limited activity increased the risk of falls by two to four times in both genders. Most fallers (92%) reported fear of future falls, and about one third of fallers reported that they went out less often as a result of their falls. Compared with native Japanese, the age-standardized prevalence of falls among Japanese-Americans was similar but about twice as high for Caucasians, which may explain the lower hip fracture risk of Japanese.
尽管日本人的骨量较低，但他们髋部骨折的发生率低于白种人。髋部骨折通常发生在跌倒后，跌倒发生率的差异可能解释了观察到的髋部骨折率的差异。为了探究这一假设，我们对日本1534名（624名男性，910名女性）65岁及以上的社区居民的跌倒及相关情况进行了研究，并将跌倒的患病率与居住在夏威夷的日裔美国人以及已发表的白种人研究进行了比较。在日本，9%的男性和19%的女性报告在过去一年中发生过一次或多次跌倒。跌倒的患病率在两性中均随年龄增长而增加，且女性高于男性。在逻辑回归模型中，患有肌肉骨骼疾病、身体残疾或活动受限会使两性跌倒的风险增加两到四倍。大多数跌倒者（92%）报告担心未来会跌倒，约三分之一的跌倒者表示由于跌倒他们外出的次数减少。与日本本地人相比，日裔美国人跌倒的年龄标准化患病率相似，但白种人约为其两倍，这可能解释了日本人髋部骨折风险较低的原因。
