DIFFERENT RISK PROFILES FOR HIP-FRACTURES AND DISTAL FOREARM FRACTURES - A PROSPECTIVE-STUDY

In a prospective cohort of elderly persons, aged 70 years and over, we examined risk indicators for which data could be easily obtained, to construct risk profiles for hip fractures and distal forearm fractures . Participants lived independently, in apartment houses for the elderl y or in homes for the elderly. At baseline, information was obtained i n 2578 subjects on age, gender, residence, mobility and the frequency of going outdoors. Mobility was measured using a walking score ranging from 1 (not able to walk independently) to 3 (able to walk independen tly for a fair distance). During the study period (median duration 3.5 years, maximum 4 years) 106 participants sustained a hip fracture and 60 participants suffered a distal forearm fracture. Women compared wi th men, adjusted for age, had a higher risk of hip fracture (adjusted relative risk (RR) = 2.4, 95% confidence interval (CI) 1.3-4.3) and di stal forearm fracture (RR = 3.7, 95% CI 1.5-9.2). Age, adjusted for ge nder, was related to hip fractures only: the relative risk of fracture for those in the highest age category (>85 years) was 9.5 (95% CI 4.3 -21.2) compared with those in the lowest age category (70-75 years). M oderately impaired walking ability compared with normal walking abilit y, adjusted for age and gender, was associated with a higher risk of h ip fracture (RR = 1.8, 95% CI 1.2-2.7) but with a lower risk of distal forearm fracture (RR = 0.4, 95% CI 0.2-0.8). The outdoor score, adjus ted for age and gender, was associated with distal forearm fractures o nly: going outdoors less than once a week, compared with three times o r more, was associated with a lower risk of fractures (RR = 0.3, 95% C I 0.1-0.9). In those living in homes for the elderly the risk of hip f racture was higher compared with those living independently (RR = 2.4, 95% CI 1.4-4.2), adjusted for age and gender. Risk profiles were cons tructed using stepwise Cox's proportional-hazards regression. The risk profile predicted probabilites of sustaining a hip fracture in a 4-ye ar period ranging from 0.4% to 25.9%, and of distal forearm fractures ranging from 0.2% to 4.5%, depending on the subject's characteristics as defined by the risk indicators. We conclude that easily obtainable risk indicators can be used in the prediction of fractures and can dis criminate among fracture types.