Dementia and Hip Fractures

Friedman, Susan M.; Menzies, Isaura B.; Bukata, Susan V.; Mendelson, Daniel A.; Kates, Stephen L.

doi:10.1177/2151458510389463

Cited by 112 publications

(89 citation statements)

References 133 publications

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“…The threefold increased risk of hip fracture associated with mental and behavioral disorders, the most prevalent of which are disorders caused by psychoactive substances, mood disorders, schizophrenia and dementia, is in accordance with the twofold to threefold increased risk observed in previous cohort studies [14, 21]. Dementia and hip fracture share several predisposing and intermediate risk factors, such as advanced age, gait impairments and increased risk of falls [27]. We also observed an increased risk of hip fracture for hypnotics and sedative drugs, commonly prescribed to people with dementia, which are previously reported to adversely affect postural stability and judgment and further predispose to injurious falls [17], particularly during nighttime hours [23].…”

Section: Discussionsupporting

confidence: 76%

The Impact of Disease and Drugs on Hip Fracture Risk

et al. 2016

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We report the risks of a comprehensive range of disease and drug categories on hip fracture occurrence using a strict population-based cohort design. Participants included the source population of a Swedish county, aged ≥50 years (n = 117,494) including all incident hip fractures during 1 year (n = 477). The outcome was hospitalization for hip fracture (ICD-10 codes S72.0–S72.2) during 1 year (2009–2010). Exposures included: prevalence of (1) inpatient diseases [International Classification of Diseases (ICD) codes A00–T98 in the National Patient Register 1987–2010] and (2) prescribed drugs dispensed in 2010 or the year prior to fracture. We present age- and sex-standardized risk ratios (RRs), risk differences (RDs) and population attributable risks (PARs) of disease and drug categories in relation to hip fracture risk. All disease categories were associated with increased risk of hip fracture. Largest risk ratios and differences were for mental and behavioral disorders, diseases of the blood and previous fracture (RRs between 2.44 and 3.00; RDs (per 1000 person-years) between 5.0 and 6.9). For specific drugs, strongest associations were seen for antiparkinson (RR 2.32 [95 % CI 1.48–1.65]; RD 5.2 [1.1–9.4]) and antidepressive drugs (RR 1.90 [1.55–2.32]; RD 3.1 [2.0–4.3]). Being prescribed ≥10 drugs during 1 year incurred an increased risk of hip fracture, whereas prescription of cardiovascular drugs or ≤5 drugs did not appear to increase risk. Diseases inferring the greatest PARs included: cardiovascular diseases PAR 22 % (95 % CI 14–29) and previous injuries (PAR 21 % [95 % CI 16–25]; for specific drugs, antidepressants posed the greatest risk (PAR 16 % [95 % CI 12.0–19.3]).Electronic supplementary materialThe online version of this article (doi:10.1007/s00223-016-0194-7) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 76%

The Impact of Disease and Drugs on Hip Fracture Risk

et al. 2016

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“…18 Because people with cognitive impairment are at an increased risk for hip fractures as a result of falling, an exploration of unique risk factors associated with serious fall-related injuries such as hip fracture is warranted to improve injury prevention practices. 32 Articles in this review included only samples consisting of people with dementia or cognitive impairment. Because the majority of studies included all types of dementia with differing pathological mechanisms, heterogeneity by disease subtype was likely present.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors Associated with Falls in Older Adults with Dementia: A Systematic Review

Fernando

Fraser

Hendriksen

et al. 2017

Physiotherapy Canada

170

116

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People with dementia fall more often than cognitively healthy older adults, but their risk factors are not well understood. A review is needed to determine a fall risk profile for this population. The objective was to critically evaluate the literature and identify the factors associated with fall risk in older adults with dementia. Articles published between January 1988 and October 2014 in EMBASE, PubMed, PsycINFO, and CINAHL were searched. Inclusion criteria were participants aged 55 years or older with dementia or cognitive impairment, prospective cohort design, detailed fall definition, falls as the primary outcome, and multi-variable regression analysis. Two authors independently reviewed and extracted data on study characteristics, quality assessment, and outcomes. Adjusted risk estimates were extracted from the articles. A total of 17 studies met the inclusion criteria. Risk factors were categorized into demographic, balance, gait, vision, functional status, medications, psychosocial, severity of dementia, and other. Risk factors varied with living setting and were not consistent across all studies within a setting. Falls in older adults with dementia are associated with multiple intrinsic and extrinsic risk factors, some shared with older adults in general and others unique to the disease. Risk factors vary between community- and institution-dwelling samples of adults with dementia or cognitive impairment.

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“…A goal of fracture fixation in the geriatric patient should be avoidance of complications and need for reoperation by adhering to solid surgical principles. 10 – 17 …”

Section: Osteoporotic Hip and Spine Fracturesmentioning

confidence: 99%

Osteoporotic Hip and Spine Fractures

Cannada

Hill

2014

Geriatr Orthop Surg Rehabil

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Hip and spine fractures represent just a portion of the burden of osteoporosis; however, these fractures require treatment and often represent a major change in lifestyle for the patient and their family. The orthopedic surgeon plays a crucial role, not only in the treatment of these injuries but also providing guidance in prevention of future osteoporotic fractures. This review provides a brief epidemiology of the fractures, details the surgical techniques, and outlines the current treatment guidelines for orthopedic surgeons.

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Dementia and Hip Fractures

Cited by 112 publications

References 133 publications

The Impact of Disease and Drugs on Hip Fracture Risk

The Impact of Disease and Drugs on Hip Fracture Risk

Risk Factors Associated with Falls in Older Adults with Dementia: A Systematic Review

Osteoporotic Hip and Spine Fractures

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