Abstract
Background: Hip fracture is one of the significant public concerns in terms of long-term care in aging society. We aimed to investigate the risk for the incidence of hip fracture focusing on disability among older adults. Methods: This was a population-based retrospective cohort study, focusing on adults aged 65 years or over who were included in the Korean National Health Insurance Service–National Sample from 2004 to 2013 (N = 90,802). Hazard ratios with 95% confidence interval (CIs) were calculated using the Cox proportional hazards model according to disability adjusted for age, household income, underlying chronic diseases, and comorbidity index. Results: The incidence of hip fracture was higher among older adults with brain disability (6.3%) and mental disability (7.5%) than among those with other types of disability, as observed during the follow-up period. Risk of hip fracture was higher among those who were mildly to severely disabled (hazard ratio for severe disability = 1.59; 95% CI, 1.33–1.89; mild = 1.68; 95% CI, 1.49–1.88) compared to those who were not disabled. Older men with mental disabilities experienced an incidence of hip fracture that was almost five times higher (hazard ratio, 4.98; 95% CI, 1.86–13.31) versus those that were not disabled. Conclusions: Older adults with mental disabilities and brain disability should be closely monitored and assessed for risk of hip fracture.
Highlights
Individuals with disabilities are vulnerable to “secondary conditions”, where there is an ever-present risk of further disease or accident/injury, as either a direct or indirect result of the pre-existing physical, mental, or social disability
We investigated the risk associated with various combinations of disability type, severity and gender (Figure 1)
The results of this study demonstrated that heterogeneity in disability should be recognized and considered, according to general characteristics, and disability type and severity
Summary
Individuals with disabilities are vulnerable to “secondary conditions”, where there is an ever-present risk of further disease or accident/injury, as either a direct or indirect result of the pre-existing physical, mental, or social disability. Prevention of such secondary conditions is of the utmost importance for promoting the health of individuals with disabilities. Results: The incidence of hip fracture was higher among older adults with brain disability (6.3%) and mental disability (7.5%) than among those with other types of disability, as observed during the follow-up period. Older men with mental disabilities experienced an incidence of hip fracture that was almost five times higher (hazard ratio, 4.98; 95% CI, 1.86–13.31) versus those that were not disabled
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