Incidence of fractures and changes over time among the aged in a Finnish municipality: a population-based 12-year follow-up

Background and aims: The incidence of fractures is high in older populations. The aim of this study was to describe the incidence of different fractures and to analyse the changes in age-adjusted yearly incidences among older persons. Methods: A prospective true cohort design. Information about fractures in 482 men and 695 women aged 65 or over living in the municipality of Lieto, south-western Finland, was collected from 1991 until 2002. Poisson’s regression model was used to analyse changes in yearly incidences. Results: During 10,040 person years (PY) of follow-up, 307 (26%) persons sustained 425 fractures. The total incidence rate of fractures was 53.4 per 1000 PY (95% confidence intervals: 47.9–59.5) in women, and 24.9 per 1000 PY (20.4–30.4) in men. The age-specific incidence of fractures increased with age in both genders. Rates of hip and wrist fractures tended to be higher in women. 7.2% subjects sustained two or more fractures during follow-up. The majority of fractures resulted from a fall, and only 3.5% were caused by extremely serious accidents. No significant changes in the age-adjusted incidences of all fractures were found in either gender during follow-up. Conclusion: Fractures are common in the aged population, and the incidence of most types of fracture is associated with increasing age. Only a minority of fractures are caused by extremely serious accidents. No significant changes in the age-adjusted yearly incidences of fractures were observed in this aged cohort during a 12-year follow-up.

[1]  E. Seeman,et al.  Epidemiology of hip and wrist fractures in Cameroon, Africa , 2003, Osteoporosis International.

[2]  J. Zuckerman,et al.  The effects of weather and seasonality on hip fracture incidence in older adults. , 2005, Orthopedics.

[3]  C Cryer,et al.  Traps for the unwary in estimating person based injury incidence using hospital discharge data , 2002, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[4]  Pekka Kannus,et al.  Hip fractures in Finland between 1970 and 1997 and predictions for the future , 1999, The Lancet.

[5]  P. Kannus,et al.  Non‐pharmacological means to prevent fractures among older adults , 2005, Annals of medicine.

[6]  A. Johansen,et al.  Trauma in elderly people: what proportion of fractures are a consequence of bone fragility? , 2000, Archives of gerontology and geriatrics.

[7]  O. Johnell,et al.  Long-Term Risk of Osteoporotic Fracture in Malmö , 2000, Osteoporosis International.

[8]  G. Jones,et al.  A Population-Based Study of Fracture Incidence in Southern Tasmania: Lifetime Fracture Risk and Evidence for Geographic Variations within the Same Country , 2001, Osteoporosis International.

[9]  P. Kannus,et al.  Increasing number and incidence of osteoporotic fractures of the proximal humerus in elderly people , 1996, BMJ.

[10]  J. Pasco,et al.  The Exclusion of High Trauma Fractures May Underestimate the Prevalence of Bone Fragility Fractures in the Community: The Geelong Osteoporosis Study , 1998, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[11]  Jerry L. Old,et al.  Vertebral compression fractures in the elderly. , 2004, American family physician.

[12]  L. Nordsletten,et al.  Epidemiology of hip fractures in Oslo, Norway. , 2001, Bone.

[13]  J. Eisman,et al.  Incidence of Hip and Other Osteoporotic Fractures in Elderly Men and Women: Dubbo Osteoporosis Epidemiology Study , 2004, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[14]  Paul W Thompson,et al.  The annual incidence and seasonal variation of fractures of the distal radius in men and women over 25 years in Dorset, UK. , 2004, Injury.

[15]  W. Wallace,et al.  Incidence of Distal Forearm Fracture in British Men and Women , 2001, Osteoporosis International.

[16]  J. Kaprio,et al.  Genetic factors and osteoporotic fractures in elderly people: prospective 25 year follow up of a nationwide cohort of elderly Finnish twins , 1999, BMJ.

[17]  O. Johnell,et al.  World-wide Projections for Hip Fracture , 1997, Osteoporosis International.

[18]  T. Blee Health care in Finland. , 1991, Health services management.

[19]  P. Sambrook,et al.  The Incidence of Hip Fracture in Four Asian Countries: The Asian Osteoporosis Study (AOS) , 2001, Osteoporosis International.

[20]  K. Freund,et al.  Menopausal hormone therapy: physician awareness of patient attitudes. , 1997, The American journal of medicine.

[21]  J. Eisman,et al.  Symptomatic fracture incidence in elderly men and women: The Dubbo osteoporosis epidemiology study (DOES) , 1994, Osteoporosis International.

[22]  H. Hagino,et al.  Changing incidence of hip, distal radius, and proximal humerus fractures in Tottori Prefecture, Japan. , 1999, Bone.

[23]  G. Sigurdsson,et al.  Fracture rate in a population-based sample of men in Reykjavik , 2004, Acta orthopaedica Scandinavica.

[24]  S. Lord,et al.  Incidence of hip fracture in New South Wales: are our efforts having an effect? , 2004, The Medical journal of Australia.

[25]  A. Jakimiuk,et al.  Vertebral fractures: a hidden problem of osteoporosis. , 2001, Medical science monitor : international medical journal of experimental and clinical research.

[26]  J. Kelsey,et al.  International Variation in the Incidence of Hip Fractures: Cross-National Project on Osteoporosis for the World Health Organization Program for Research on Aging , 1999, Osteoporosis International.

[27]  R. Sulkava,et al.  The changing picture of hip fractures: dramatic change in age distribution and no change in age-adjusted incidence within 10 years in Central Finland. , 1999, Bone.

[28]  J. Kelsey,et al.  Predictors of ankle and foot fractures in older women , 1996, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[29]  N. Breslow,et al.  Statistical methods in cancer research. Volume II--The design and analysis of cohort studies. , 1987, IARC scientific publications.

[30]  R. Palmer,et al.  Prevalence, Incidence, and Risk Factors Associated with Hip Fractures in Community‐Dwelling Older Mexican Americans: Results of the Hispanic EPESE Study , 2000, Journal of the American Geriatrics Society.

[31]  A. Silman,et al.  Falls explain between-center differences in the incidence of limb fracture across Europe. , 2002, Bone.

[32]  J. Pasco,et al.  Age- and Gender-Specific Rate of Fractures in Australia: A Population-Based Study , 1999, Osteoporosis International.

[33]  A. Silman,et al.  Incidence of Limb Fracture across Europe: Results from the European Prospective Osteoporosis Study (EPOS) , 2002, Osteoporosis International.

[34]  S. Kivelä,et al.  Prevalence of asthma in elderly Finns. , 1994, Journal of clinical epidemiology.

[35]  Marija Bulajic-Kopjar,et al.  Seasonal variations in incidence of fractures among elderly people , 2000, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[36]  S. Cummings,et al.  Epidemiology and predictors of fractures associated with osteoporosis. , 1997, The American journal of medicine.

[37]  T. Spector,et al.  Risk of Wrist Fracture in Women Is Heritable and Is Influenced by Genes That Are Largely Independent of Those Influencing BMD , 2004, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[38]  W. O'Fallon,et al.  Fracture Incidence in Olmsted County, Minnesota: Comparison of Urban with Rural Rates and Changes in Urban Rates Over time , 1999, Osteoporosis International.

[39]  P. C. Amadio,et al.  Long-Term Trends in the Incidence of Distal Forearm Fractures , 1998, Osteoporosis International.

[40]  S. Lo,et al.  Fracture incidence in England and Wales: a study based on the population of Cardiff. , 1997, Injury.

[41]  O. Johnell,et al.  Hip fractures in Nordic cities: difference in incidence. , 1995, Annales chirurgiae et gynaecologiae.

[42]  O. Johnell,et al.  Incidence of hip fractures in Malmö, Sweden, 1992-1995. A trend-break. , 1999, Acta orthopaedica Scandinavica.

[43]  J. Pasco,et al.  Fracture rates lower in rural than urban communities: the Geelong Osteoporosis Study , 2002, Journal of epidemiology and community health.

[44]  P. Simpson,et al.  Statistical methods in cancer research , 2001, Journal of surgical oncology.