Abstract
BackgroundSeveral risk factors are associated to hip fractures. It seems that different hip fracture types have different etiologies. In this study, we evaluated the lifestyle-related risk factors for cervical and trochanteric hip fractures in older women over a 13-year follow-up period.MethodsThe study design was a prospective, population-based study consisting of 1681 women (mean age 72 years). Seventy-three percent (n = 1222) participated in the baseline measurements, including medical history, leisure-time physical activity, smoking, and nutrition, along with body anthropometrics and functional mobility. Cox regression was used to identify the independent predictors of cervical and trochanteric hip fractures.ResultsDuring the follow-up, 49 cervical and 31 trochanteric fractures were recorded. The women with hip fractures were older, taller, and thinner than the women with no fractures (p < 0.05). Low functional mobility was an independent predictor of both cervical and trochanteric fractures (HR = 3.4, 95% CI 1.8-6.6, and HR = 5.3, 95% CI 2.5-11.4, respectively). Low baseline physical activity was associated with an increased risk of hip fracture, especially in the cervical region (HR = 2.5, 95% CI 1.3-4.9). A decrease in cervical fracture risk (p = 0.002) was observed with physically active individuals compared to their less active peers (categories: very low or low, moderate, and high). Moderate coffee consumption and hypertension decreased the risk of cervical fractures (HR = 0.4, 95% CI 0.2-0.8, for both), while smoking was a predisposing factor for trochanteric fractures (HR = 3.2, 95% CI 1.1-9.3).ConclusionsImpaired functional mobility, physical inactivity, and low body mass may increase the risk for hip fractures with different effects at the cervical and trochanteric levels.
Highlights
Several risk factors are associated to hip fractures
Moderate coffee consumption (>3 cups per day) and arterial hypertension decreased the risk of cervical fractures (HR = 0.4, 95% Confidence Interval (CI) 0.2-0.8, and hazard ratios (HR) = 0.4, 95% confidence intervals (95% CI) 0.2-0.8, respectively), whereas daily smoking was a risk factor for trochanteric fractures (HR = 3.2, 95% CI 1.1-9.3)
Other clinical factors appeared to differ between the hip fracture sites: hypertension and coffee consumption of more than three cups per day decreased the risk of cervical hip fractures, while daily smoking increased the risk of trochanteric hip fractures
Summary
Several risk factors are associated to hip fractures. It seems that different hip fracture types have different etiologies. We evaluated the lifestyle-related risk factors for cervical and trochanteric hip fractures in older women over a 13-year follow-up period. During the last few decades, physical inactivity has been shown to be associated with a greater hip fracture risk among older people [7]. Prospective studies, moderate or high leisure time physical activity has been associated with a 28-42% reduction in hip fracture risk [6,8,9,10]. Physical activity has several advantages, including increased bone strength [11] and decreased risk of falling [12]. Because approximately 90% of all hip fractures occur as the consequences of falls [19], decreasing the risk of falling is crucial
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