Seasonal variations in incidence of fractures among elderly people

Objective—To investigate seasonal variations in the incidence of fall related fractures among people 65 years and older. Population and methods—A prospective, population based cohort study was performed on people aged 65 years and older followed up from 1990 to 1997, a total of 459 904 person years. Cases were identified through a prospective registration system. Results—There were 10 992 (2390 per 100 000 person years) fall related fractures. The risk was higher in the colder seasons (October through March) among people aged 65–79 years (relative risk (RR) = 1.39, 95% confidence interval (CI) 1.32 to 1.47) and in people aged 80 years and older (RR = 1.17, 95% CI 1.09 to 1.22). For arm fractures, the RR was 1.69 (95% CI 1.56 to 1.83) among people aged 65–79 years and 1.30 (95% CI 1.13 to 1.43) among those aged 80 years and older. The RR for hip fractures was 1.27 (95% CI 1.15 to 1.37) among people aged 65–79 years and 1.08 (95% CI 1.00 to 1.15) for people aged 80 years and older. Slipping on ice and snow seems to entirely explain the excessive incidence of hip and arm fractures during winter months. Conclusion—Season affects the incidence of all types of fractures in elderly people. Slipping on ice and snow seems to be a causal mechanism behind the seasonal effect. Preventive measures targeting this causal mechanism are likely to reduce the risk of fracture, but the size of the effect is difficult to estimate with certainty.

[1]  J. Zuckerman,et al.  Circumstances of Falls Causing Hip Fractures in the Elderly , 2003, Clinical orthopaedics and related research.

[2]  P. Morreale,et al.  Epidemiology of hip fractures in Siena, Italy, 1975-1985. , 1989, Clinical orthopaedics and related research.

[3]  S. Allison,et al.  UNDERNUTRITION, HYPOTHERMIA, AND INJURY IN ELDERLY WOMEN WITH FRACTURED FEMUR: AN INJURY RESPONSE TO ALTERED METABOLISM? , 1983, The Lancet.

[4]  L. Adelson,et al.  A study of racial difference, seasonal variation, and temporal variation in hip fracture-related mortality, Cuyahoga County, Ohio 1958--1962, 1968--1972. , 1977, Journal of chronic diseases.

[5]  J. G. Avery.  Fractures during ice and snow. , 1982, British medical journal.

[6]  A. Campbell,et al.  Falls, elderly women and the cold. , 1988, Gerontology.

[7]  B. Riggs,et al.  Epidemiology of fractures of the proximal femur in Rochester, Minnesota. , 1980, Clinical orthopaedics and related research.

[8]  L. Valenti,et al.  The seasonality of hip fracture and its relationship with weather conditions in New South Wales. , 2010, Australian journal of public health.

[9]  J G Avery,et al.  Epidemic of fractures during period of ice and snow , 1981 .

[10]  C. Weinberg,et al.  Use and misuse of population attributable fractions. , 1998, American journal of public health.

[11]  N. Cardoe,et al.  Gastrointestinal haemorrhage and benoxaprofen. , 1982, British medical journal.

[12]  F. Piette,et al.  [Epidemiology of fractures of the proximal femur]. , 1992, Presse medicale.

[13]  G. Andersson,et al.  Epidemiology of hip fractures in Göteborg, Sweden, 1940-1983. , 1984, Clinical orthopaedics and related research.

[14]  I. Stewart.  Fractures of neck of femur; incidence and implications. , 1955, British medical journal.

[15]  M. Graffar.  [Modern epidemiology]. , 1971, Bruxelles medical.

[16]  M. Passeri,et al.  Seasonal variation in the incidence of hip fractures in Emilia-Romagna and Parma. , 1993, Bone.

[17]  S. Holmberg,et al.  Statistical analysis of femoral neck fractures based on 3053 cases. , 1987, Clinical orthopaedics and related research.

[18]  J. Brody,et al.  Seasonal variation in the incidence of hip fracture among white persons aged 65 years and older in the United States, 1984-1987. , 1991, American journal of epidemiology.

[19]  L. Melton,et al.  Population-based study of the contribution of weather to hip fracture seasonality. , 1995, American journal of epidemiology.

[20]  C. Joslin,et al.  Will breast self-examination save lives? , 1982 .