Do Sex Differences Exist in Rates of Falls and Fractures in Hutterite, Rural, and Nonrural Populations, Aged 20 to 66 Years?

Abstract

Background Falls and fractures are a major public health concern with an economic impact of more than USD 19 billion per year. Extensive research into the risk of falls and fractures in elderly populations has been performed; however, little is known about fall or fracture risk in younger populations. Additionally, sex-and population-specific (rural versus nonrural) fall and fracture risk may be important in identifying groups most at risk in an effort to develop preventive measures. Questions/purposes The purpose of this study was to determine whether sex and population (rural versus nonrural) differences exist in fall and fracture rates.Methods Data from 1256 (538 men) participants of the South Dakota Rural Bone Health Study, a population-based cohort study, including those living a rural lifestyle (n = 349 non-Hutterites and 572 Hutterites) and a nonrural lifestyle (n = 335), were used to address our a priori hypotheses. Health histories, physical activity recall, anthropometric measurements, and dual-energy xray absorptiometry measurements of body composition were obtained longitudinally from participants every 18 months for 7.5 years. Falls and fractures were self-reported and fractures were confirmed through medical record review. Incidence rates were calculated as the number of falls or fractures per 1000 person-years and generalized estimating equations determined the association of sex and population group with fall and fractures rates while accounting for the repeated longitudinal measurements on the same person. All models adjusted for age group, percent time in moderate and vigorous physical activity, lean and fat mass, grip strength, and previous diagnosis of osteoarthritis. Results Males aged 39 years and younger had a 135% greater fall risk than females in the same age category (p = 0.03), but there was no differences between males and females 40 years of age or older (p = 0.26; age-by-sex interaction, p = 0.05). No sex differences were observed for fracture risk. After controlling for covariates, rural and nonrural individuals fell at higher rates than Hutterites (84% and 50%, respectively, p \ 0.001). Additionally,

The Epidemiology of Adult Fractures According to the AO/OTA Fracture Classification

“…The relative increase of lower extremity fractures' frequency after the age of seventy may be explained by the exponential increase in hip fractures, which was previously reported to occur due to a variety of factors: Decreased bone quality, impaired neuromuscular responses, and increased risk of falling. [3,16,19] On the one hand, the rates of open and pathological fractures were also reported in the present study, as 11.6% and 1.8%, respectively. On the other hand, the overall mortality rate related with adult fractures was also found as 0.4%.…”

“…[ 3 , 13 – 15 ] Conversely, it was demonstrated that males aged 39 and younger had 135% greater fall risk than females in the same age category and that no sex differences were observed for fracture risk. [ 16 ] However, the results of this study may be challenged by their report being in a much smaller population in a limited geographical region, compared with other studies. The only female predominance was in proximal humerus (AO/OTA 11) fractures in our study.…”

“…The relative increase of lower extremity fractures’ frequency after the age of seventy may be explained by the exponential increase in hip fractures, which was previously reported to occur due to a variety of factors: Decreased bone quality, impaired neuromuscular responses, and increased risk of falling. [ 3 , 16 , 19 ]…”

Helicobacter pylori Related Diseases and Osteoporotic Fractures (Narrative Review)

“…Comparison of the role of sex and age in OP/OF and in HPI is of interest. OP/OF affects more females in the older/postmenopausal age (the F:M ratio among hip fracture patients is 2:1 [ 401 ]) and the incidence of OFs increases exponentially with age >70 years in both genders [ 402 , 403 , 404 , 405 ], while males <40 years of age had higher fall rates [ 406 ]. Among adults, a small male predominance of HPI-related outcomes has been found in a meta-analysis based on 169 studies (OR 1.12, 95% CI: 1.09, 1.15) [ 407 ].…”