Why Aboriginal and Torres Strait Islander Australians fall and fracture: the codesigned Study of Indigenous Muscle and Bone Ageing (SIMBA) protocol

Zengin, Ayse; Shore-Lorenti, Catherine; Sim, Marc; Maple-Brown, Louise; Brennan-Olsen, Sharon L.; Lewis, Joshua R.; Ockwell, Jennifer; Walker, Troy; Scott, David; Ebeling, Peter R.

doi:10.1136/bmjopen-2021-056589

BMJ Open

2022

DOI: 10.1136/bmjopen-2021-056589

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Why Aboriginal and Torres Strait Islander Australians fall and fracture: the codesigned Study of Indigenous Muscle and Bone Ageing (SIMBA) protocol

Ayse Zengin

Catherine Shore-Lorenti

Marc Sim

et al.

Abstract: ObjectivesAboriginal and Torres Strait Islander Australians have a substantially greater fracture risk, where men are 50% and women are 26% more likely to experience a hip fracture compared with non-Indigenous Australians. Fall-related injuries in this population have also increased by 10%/year compared with 4.3%/year in non-Indigenous Australians. This study aims to determine why falls and fracture risk are higher in Aboriginal and Torres Strait Islander Australians.SettingAll clinical assessments will be per… Show more

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“…Second, for countries with more racial or ethnic diversity, different incidence rates among groups of varying racial or ethnic backgrounds were not considered (eg, US, Singapore, and Australia). ( 7 ) Although the data presented are very valuable and important, further work is needed to fill in these existing gaps.…”

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confidence: 99%

Hip Fractures and Aging: A Global Problem Requiring Coordinated Global Solutions

Ebeling

2023

J of Bone & Mineral Res

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S ing and colleagues (1) provide a timely update on global hip fracture incidence and projections out to 2050. These significant data, derived from a very large international cohort of 4,115,046 hip fracture cases, are highly likely to inform public health policy internationally. The authors demonstrate surprising highly variable age-and sex-standardized incidence rates of hip fractures ranging from 95.1 (Brazil) to 315.9 (Denmark) per 100,000 population. Importantly, despite incidence rates decreasing over the study period, the total number of hip fractures is estimated to nearly double from 2018 to 2050 because of an increased population of older individuals, particularly in developing countries. Post-fracture treatment within the first year after a hip fracture also varied, ranging from 11.5% (Germany) to 50.3% (United Kingdom). All-cause mortality rates varied, ranging from the lowest level of 14.4% (Singapore) to the highest level of 28.3% (United Kingdom), despite its higher post-fracture treatment rates. Males fared badly in all domains examined. Men had a lower use of anti-osteoporosis medication than females, higher rates of all-cause mortality, and a larger increase in the projected number of hip fractures by 2050, indicating a missed opportunity. These data confirm osteoporosis in men remains both underrecognized and undertreated. (2) Overall, the study highlights a continuing and unacceptable osteoporosis treatment gap. The growing aging population is overcoming any gains made by reducing hip fracture incidence rates.However, this study has a couple of limitations. The first is that data from the world's most populous nations or regions, namely China, India, and Africa, are not included. Recent Chinese data also show regional variation in hip fracture incidence rates and a lack of a sex difference, being very high at 1065 and 1069 per 100,000, respectively, for men and women. (3) In India, hip fracture rates were 105 and 159 per 100,000 among men and women, respectively, (4) whereas 1-year mortality was very high at 42%. (5) In Africa, data confined to the Cameroon (6) and Morocco show relatively low hip fracture incidence rates of 57.1 and 43.7 per 100,000 for women and men, respectively, being like those of African Americans. Second, for countries with more racial or ethnic diversity, different incidence rates among groups of varying racial or ethnic backgrounds were not considered (eg, US, Singapore, and Australia). (7) Although the data presented are very valuable and important, further work is needed to fill in these existing gaps.

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confidence: 99%

Hip Fractures and Aging: A Global Problem Requiring Coordinated Global Solutions

Ebeling

2023

J of Bone & Mineral Res

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The burden of rheumatologic disease in Aboriginal and Torres Strait Islander Australians

Sines,

Cai,

Cashman

et al. 2024

Internal Medicine Journal

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The objective of this article is to summarise the current knowledge regarding the prevalence of six rheumatological conditions in indigenous Australians – rheumatoid arthritis (RA), osteoarthritis (OA), osteoporosis (OSP), systemic lupus erythematosus (SLE), gout and musculoskeletal (MSK) pain. Online medical literature databases were searched for ‘indigenous’, ‘Aboriginal’ and ‘Torres Strait Islander’, as well as the names of the six conditions. Other included search terms were ‘crystal’, ‘urate’, ‘arthritis’ and ‘arthropathy’. No limitations were placed on publication data or language. Forty‐five articles examining the prevalence of the six conditions were identified. Based on the published literature, SLE appears to have a higher prevalence, while RA appears to have a lower prevalence in indigenous Australians compared to the non‐indigenous community. MSK pain is prevalent, has a significant impact on indigenous people and is perceived as an important area of need. There is a paucity of data regarding these conditions in indigenous Australians. This may be impacted by the uncertainty of case ascertainment by self‐report, differences in disease phenotypes and prevalence between the metropolitan compared to the rural or remote indigenous population, and difficulty with access to healthcare. Further studies in conjunction with local indigenous communities are needed to accurately determine the burden of rheumatological disease in the indigenous population. This will assist with resource and workforce planning to deliver culturally appropriate interventions. Strategies for future clinical work and research include the development and dissemination of culturally safe rheumatology resources, rheumatology training of Aboriginal Health Workers and wider integration of rheumatology clinics into community‐controlled Aboriginal Health Services.

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Why Aboriginal and Torres Strait Islander Australians fall and fracture: the codesigned Study of Indigenous Muscle and Bone Ageing (SIMBA) protocol

Cited by 2 publications

References 55 publications

Hip Fractures and Aging: A Global Problem Requiring Coordinated Global Solutions

Hip Fractures and Aging: A Global Problem Requiring Coordinated Global Solutions

The burden of rheumatologic disease in Aboriginal and Torres Strait Islander Australians

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