Amount of Social Contact and Hip Fracture Mortality

Abstract

OBJECTIVES-To study the association between amount of social contact and mortality after hip fracture in elderly participants. DESIGN-Prospective cohort.SETTING-Community residents of Baltimore, Maryland. PARTICIPANTS-Six hundred seventy-four elderly participants.MEASUREMENTS-Amount of telephone and direct personal contact between participants and their relatives and friends and mortality up to 2 years after fracture. RESULTS-Nosocial contact with friends during the 2 weeks before the fracture was associated with a five times greater risk of death over 2 years than daily contact with friends during the 2 weeks before the fracture (hazard ratio (HR) = 5.04, 95% confidence interval (CI) = 2.75-9.23). Participants with less than daily contact were also at greater risk of dying, although the CI spanned 1 (HR = 1.76, 95% CI = 0.99-3.13). Participants who had no contact with family members prefracture were more than twice as likely to die as those who communicated daily during the 2 weeks before fracture (HR = 2.26, 95% CI = 1.36-3.77). Participants who had less than daily contact were also more than twice as likely to die (HR = 2.55, 95% CI = 1.65-3.94).CONCLUSION-This study suggests that lower social contact before hip fracture is associated with poorer survival after 2 years. Conflict of Interest:The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that none of the authors have any financial or any other kind of personal conflicts with this manuscript. There is evidence that social interaction is associated with better survival in elderly persons, 10-14 even after myocardial infarction or stroke. [15][16][17][18] Other evidence suggests that social interaction is associated with better likelihood of functional recovery, which may indirectly improve the prospect of survival, [19][20][21][22] but what is not known is whether social interaction is associated with greater survival in frail elderly participants who have suffered hip fracture-a condition associated with high mortality. Because some of the risk factors for fracture differ from those for other conditions, it is important to understand whether social interaction is associated with recovery.The aim of this study was to evaluate whether frequent social contact is associated with greater likelihood of survival after hip fracture. It is a novel approach to examine the relationship between pre-and postfracture social support and mortality. Also, it extends previous work by examining the association between social network interaction and survival from hip fracture in a large cohort of patients, providing better adjustment for potentially confounding risk factors and by doing so over 2 years after fracture. METHODS ParticipantsParticipants in this study were subjects in the second Baltimore Hip Study cohort, which examined changes in physical capacity and quality of life in patients aged 65 and older who were admitted from the community to one of eight Baltimore-area hospitals in 1990 and 1991 for ...

Understanding the role of social factors in recovery after hip fractures: A structured scoping review

“…Studies represent a wide range of geographical locations: Canada, Denmark, Finland, Italy, Korea, Norway, Portugal, Spain, United Kingdom and the United States of America (see Figure ). All studies collected data on post‐fracture outcomes except for two studies that also looked at pre‐fracture subjective recalled outcomes (Cobey et al, ; Mortimore et al, ). Fifteen studies primarily investigated the relationship between social factors and recovery post hip fracture, whereas four studies looked at social factors as a secondary objective (Hongisto, Nuotio, Luukkaala, Vaisto, & Pihlajamaki, ; Morghen et al, ; Orive et al, ; Sylliaas et al, ).…”

Excess mortality following hip fracture: a systematic epidemiological review

“…In their analysis of data from the Scottish Hip Fracture Audit, Holt and coworkers found that, compared with hip fracture patients aged 50 to 59 years, the OR for death was 1.78 (95% CI, 0.95-0.33) for those aged 60 to 69 years, 3.46 (95% CI, 1.94-6.15) for those aged 70 to 79 years, 5.68 (95% CI, 3.21-10.1) for those aged 80 to 89 years, and 7.11 (95% CI, 3.98-12.7) for those aged 90 years and over [60]. Similarly, Mortimore and co-workers found that among community residents of Baltimore (USA), the RR for death was 1.13 (95% CI, 0.76-1.67) for hip fracture patients aged 75 to 84 years and 1.59 (95% CI, 1.06-2.38) for those aged 85 years and over when compared with those aged 65 to 74 years [61].…”

“…Two studies conducted risk analyses using younger patients with hip fracture as controls [60,61]. Both studies found that the RR for death was increased in older compared with younger age groups.…”

Do Older People Benefit from Having a Confidant? An Oklahoma Physicians Resource/Research Network (OKPRN) Study

“…To analyze bivariate associations between baseline variables and death, 2 and t tests were used. Kaplan-Meier analysis was performed to compare unadjusted survival curves; the Wilcoxon statistic was used to assess significance.…”

“…For example, a prospective cohort of 674 elderly, communitydwelling participants found that those with no social contact with friends or family during the 2 weeks before a hip fracture had a 5 times greater risk of death during the following 2-year period than those who had daily social contact. 2 A prospective study of 589 individuals monitored for 12 months after myocardial infarction showed that lack of a confidantnot previous depression-was associated with an adverse outcome after myocardial infarction. 1 Loneliness and living alone may be concomitant with the lack of a confidant and have been shown to be predictors of functional decline and death among older people.…”