Skip to main content
Erschienen in: Osteoporosis International 9/2007

01.09.2007 | Original Article

Effect of seasonality and weather on fracture risk in individuals 65 years and older

verfasst von: H. A. Bischoff-Ferrari, J. E. Orav, J. A. Barrett, J. A. Baron

Erschienen in: Osteoporosis International | Ausgabe 9/2007

Einloggen, um Zugang zu erhalten

Abstract

Summary

In this large population-based study, fracture rates for hips, distal forearms, proximal humeri, and ankles were higher in winter than in other seasons, although the winter peak was small for hip fractures (p < 0.05 at all sites). Younger age between 65 and 80, living in warmer states and male gender were associated with increased winter morbidity due to fractures.

Introduction

The objective was to investigate seasonal variation in the incidence of four common fractures, and explore the association of weather with risk.

Methods

Population-based analysis of individuals age 65 and older, including fractures of the hip, the distal forearm, the proximal humerus and the ankle. Weather information was obtained from the US National Oceanic and Atmospheric Administration website.

Results

For all fractures, rates were highest in winter and lowest in summer (p < 0.05 at all sites). Winter peaks were more pronounced in warm climate states, in men, and in those younger than 80 years old. In winter, total snowfall was associated with a reduced risk of hip fracture (−5% per 20 inches) but an increased risk of non-hip fractures (6–12%; p < 0.05 at all sites). In summer, hip fracture risk tended to be lower during sunny weather (− 3% per 2 weeks of sunny days; p = 0.13), while other fractures were increased (15%–20%; p < 0.05) in sunny weather.

Conclusion

Fractures contribute considerably to winter morbidity in older individuals. Younger age between 65 and 80, living in warmer states and male gender are risk factors for increased winter morbidity due to fractures. Weather affects hip fracture risk differently than the other fractures studied.
Literatur
1.
Zurück zum Zitat Douglas AS, Allan TM, Rawles JM (1991) Composition of seasonality of disease. Scott Med J 36(3):76–82PubMed Douglas AS, Allan TM, Rawles JM (1991) Composition of seasonality of disease. Scott Med J 36(3):76–82PubMed
2.
Zurück zum Zitat Wilkinson P, Pattenden S, Armstrong B et al (2004) Vulnerability to winter mortality in elderly people in Britain: population based study. BMJ 17:17 Wilkinson P, Pattenden S, Armstrong B et al (2004) Vulnerability to winter mortality in elderly people in Britain: population based study. BMJ 17:17
3.
Zurück zum Zitat Wilkinson P, Pattenden S, Armstrong B et al (2004) Vulnerability to winter mortality in elderly people in Britain: population based study. BMJ 329(7467):647, Epub 2004 Aug 17PubMedCrossRef Wilkinson P, Pattenden S, Armstrong B et al (2004) Vulnerability to winter mortality in elderly people in Britain: population based study. BMJ 329(7467):647, Epub 2004 Aug 17PubMedCrossRef
4.
Zurück zum Zitat Lieberman D, Friger MD (1999) Seasonal variation in hospital admissions for community-acquired pneumonia: a 5-year study. J Infect 39(2):134–140PubMedCrossRef Lieberman D, Friger MD (1999) Seasonal variation in hospital admissions for community-acquired pneumonia: a 5-year study. J Infect 39(2):134–140PubMedCrossRef
5.
Zurück zum Zitat Vilkman S, Keistinen T, Tuuponen T, Kivela SL (1996) Seasonal variation in hospital admissions for chronic obstructive pulmonary disease in Finland. Arctic Med Res 55(4):182–186PubMed Vilkman S, Keistinen T, Tuuponen T, Kivela SL (1996) Seasonal variation in hospital admissions for chronic obstructive pulmonary disease in Finland. Arctic Med Res 55(4):182–186PubMed
6.
Zurück zum Zitat Spencer FA, Goldberg RJ, Becker RC, Gore JM (1998) Seasonal distribution of acute myocardial infarction in the second National Registry of Myocardial Infarction. J Am Coll Cardiol 31(6):1226–1233PubMedCrossRef Spencer FA, Goldberg RJ, Becker RC, Gore JM (1998) Seasonal distribution of acute myocardial infarction in the second National Registry of Myocardial Infarction. J Am Coll Cardiol 31(6):1226–1233PubMedCrossRef
7.
Zurück zum Zitat Jacobsen SJ, Sargent DJ, Atkinson EJ, O’Fallon WM, Melton LJ 3rd (1995) Population-based study of the contribution of weather to hip fracture seasonality. Am J Epidemiol 141(1):79–83PubMed Jacobsen SJ, Sargent DJ, Atkinson EJ, O’Fallon WM, Melton LJ 3rd (1995) Population-based study of the contribution of weather to hip fracture seasonality. Am J Epidemiol 141(1):79–83PubMed
8.
Zurück zum Zitat Bulajic-Kopjar M (2000) Seasonal variations in incidence of fractures among elderly people. Inj Prev 6(1):16–19PubMedCrossRef Bulajic-Kopjar M (2000) Seasonal variations in incidence of fractures among elderly people. Inj Prev 6(1):16–19PubMedCrossRef
9.
Zurück zum Zitat Hemenway D, Colditz GA (1990) The effect of climate on fractures and deaths due to falls among white women. Accident Anal Prev 22(1):59–65CrossRef Hemenway D, Colditz GA (1990) The effect of climate on fractures and deaths due to falls among white women. Accident Anal Prev 22(1):59–65CrossRef
10.
Zurück zum Zitat Jacobsen SJ, Goldberg J, Miles TP, Brody JA, Stiers W, Rimm AA (1991) Seasonal variation in the incidence of hip fracture among white persons aged 65 years and older in the United States, 1984–1987. Am J Epidemiol 133(10):996–1004PubMed Jacobsen SJ, Goldberg J, Miles TP, Brody JA, Stiers W, Rimm AA (1991) Seasonal variation in the incidence of hip fracture among white persons aged 65 years and older in the United States, 1984–1987. Am J Epidemiol 133(10):996–1004PubMed
11.
Zurück zum Zitat Lau EM, Gillespie BG, Valenti L, O’Connell D (1995) The seasonality of hip fracture and its relationship with weather conditions in New South Wales. Aust J Public Health 19(1):76–80PubMedCrossRef Lau EM, Gillespie BG, Valenti L, O’Connell D (1995) The seasonality of hip fracture and its relationship with weather conditions in New South Wales. Aust J Public Health 19(1):76–80PubMedCrossRef
12.
Zurück zum Zitat Mannius S, Mellstrom D, Oden A, Rundgren A, Zetterberg C (1987) Incidence of hip fracture in western Sweden 1974–1982. Comparison of rural and urban populations. Acta Orthop Scand 58(1):38–42PubMedCrossRef Mannius S, Mellstrom D, Oden A, Rundgren A, Zetterberg C (1987) Incidence of hip fracture in western Sweden 1974–1982. Comparison of rural and urban populations. Acta Orthop Scand 58(1):38–42PubMedCrossRef
13.
Zurück zum Zitat Zetterberg C, Andersson GB (1982) Fractures of the proximal end of the femur in Goteborg, Sweden, 1940–1979. Acta Orthop Scand 53(3):419–426PubMedCrossRef Zetterberg C, Andersson GB (1982) Fractures of the proximal end of the femur in Goteborg, Sweden, 1940–1979. Acta Orthop Scand 53(3):419–426PubMedCrossRef
14.
Zurück zum Zitat Jacobsen SJ, Sargent DJ, Atkinson EJ, O’Fallon WM, Melton LJ 3rd (1999) Contribution of weather to the seasonality of distal forearm fractures: a population-based study in Rochester, Minnesota. Osteoporos Int 9(3):254–259PubMedCrossRef Jacobsen SJ, Sargent DJ, Atkinson EJ, O’Fallon WM, Melton LJ 3rd (1999) Contribution of weather to the seasonality of distal forearm fractures: a population-based study in Rochester, Minnesota. Osteoporos Int 9(3):254–259PubMedCrossRef
15.
Zurück zum Zitat Ralis ZA (1981) Epidemic of fractures during period of snow and ice. Br Med J (Clin Res Ed) 282(6264):603–605 Ralis ZA (1981) Epidemic of fractures during period of snow and ice. Br Med J (Clin Res Ed) 282(6264):603–605
16.
Zurück zum Zitat O’Neill TW, Marsden D, Adams JE, Silman AJ (1996) Risk factors, falls, and fracture of the distal forearm in Manchester, UK. J Epidemiol Community Health 50(3):288–292PubMed O’Neill TW, Marsden D, Adams JE, Silman AJ (1996) Risk factors, falls, and fracture of the distal forearm in Manchester, UK. J Epidemiol Community Health 50(3):288–292PubMed
17.
Zurück zum Zitat Graafmans WC, Ooms ME, Bezemer PD, Bouter LM, Lips P (1996) Different risk profiles for hip fractures and distal forearm fractures: a prospective study. Osteoporos Int 6(6):427–431PubMedCrossRef Graafmans WC, Ooms ME, Bezemer PD, Bouter LM, Lips P (1996) Different risk profiles for hip fractures and distal forearm fractures: a prospective study. Osteoporos Int 6(6):427–431PubMedCrossRef
18.
Zurück zum Zitat Keegan TH, Kelsey JL, King AC, Quesenberry CP Jr, Sidney S (2004) Characteristics of fallers who fracture at the foot, distal forearm, proximal humerus, pelvis, and shaft of the tibia/fibula compared with fallers who do not fracture. Am J Epidemiol 159(2):192–203PubMedCrossRef Keegan TH, Kelsey JL, King AC, Quesenberry CP Jr, Sidney S (2004) Characteristics of fallers who fracture at the foot, distal forearm, proximal humerus, pelvis, and shaft of the tibia/fibula compared with fallers who do not fracture. Am J Epidemiol 159(2):192–203PubMedCrossRef
19.
Zurück zum Zitat Nevitt MC, Cummings SR (1994) Type of fall and risk of hip and wrist fractures: the study of osteoporotic fractures. J Am Geriatr Soc 42(8):909PubMed Nevitt MC, Cummings SR (1994) Type of fall and risk of hip and wrist fractures: the study of osteoporotic fractures. J Am Geriatr Soc 42(8):909PubMed
20.
Zurück zum Zitat Carter SE, Campbell EM, Sanson-Fisher RW, Gillespie WJ (2000) Accidents in older people living at home: a community-based study assessing prevalence, type, location and injuries. Aust N Z J Public Health 24(6):633–636PubMed Carter SE, Campbell EM, Sanson-Fisher RW, Gillespie WJ (2000) Accidents in older people living at home: a community-based study assessing prevalence, type, location and injuries. Aust N Z J Public Health 24(6):633–636PubMed
21.
Zurück zum Zitat Campbell AJ, Borrie MJ, Spears GF, Jackson SL, Brown JS, Fitzgerald JL (1990) Circumstances and consequences of falls experienced by a community population 70 years and over during a prospective study. Age Ageing 19(2):136–141PubMedCrossRef Campbell AJ, Borrie MJ, Spears GF, Jackson SL, Brown JS, Fitzgerald JL (1990) Circumstances and consequences of falls experienced by a community population 70 years and over during a prospective study. Age Ageing 19(2):136–141PubMedCrossRef
22.
Zurück zum Zitat Bastow MD, Rawlings J, Allison SP (1983) Undernutrition, hypothermia, and injury in elderly women with fractured femur: an injury response to altered metabolism? Lancet 1(8317):143–146PubMedCrossRef Bastow MD, Rawlings J, Allison SP (1983) Undernutrition, hypothermia, and injury in elderly women with fractured femur: an injury response to altered metabolism? Lancet 1(8317):143–146PubMedCrossRef
23.
Zurück zum Zitat Bischoff HA, Stahelin HB, Dick W et al (2003) Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res 18(2):343–351PubMedCrossRef Bischoff HA, Stahelin HB, Dick W et al (2003) Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res 18(2):343–351PubMedCrossRef
24.
Zurück zum Zitat Bischoff-Ferrari HA, Orav EJ, Dawson-Hughes B (2006) Effect of cholecalciferol plus calcium on falling in ambulatory older men and women: a 3-year randomized controlled trial. Arch Intern Med 166(4):424–430PubMedCrossRef Bischoff-Ferrari HA, Orav EJ, Dawson-Hughes B (2006) Effect of cholecalciferol plus calcium on falling in ambulatory older men and women: a 3-year randomized controlled trial. Arch Intern Med 166(4):424–430PubMedCrossRef
25.
Zurück zum Zitat Bischoff-Ferrari HA, Dawson-Hughes B, Willett CW et al (2004) Effect of vitamin D on falls: a meta-analysis. JAMA 291(16):1999–2006PubMedCrossRef Bischoff-Ferrari HA, Dawson-Hughes B, Willett CW et al (2004) Effect of vitamin D on falls: a meta-analysis. JAMA 291(16):1999–2006PubMedCrossRef
26.
Zurück zum Zitat Chapuy MC, Arlot ME, Duboeuf F et al (1992) Vitamin D3 and calcium to prevent hip fractures in the elderly women. N Engl J Med 327(23):1637–1642PubMedCrossRef Chapuy MC, Arlot ME, Duboeuf F et al (1992) Vitamin D3 and calcium to prevent hip fractures in the elderly women. N Engl J Med 327(23):1637–1642PubMedCrossRef
27.
Zurück zum Zitat Trivedi DP, Doll R, Khaw KT (2003) Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial. BMJ 326(7387):469PubMedCrossRef Trivedi DP, Doll R, Khaw KT (2003) Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial. BMJ 326(7387):469PubMedCrossRef
28.
Zurück zum Zitat Baron JA, Karagas M, Barrett J et al (1996) Basic epidemiology of fractures of the upper and lower limb among Americans over 65 years of age. Epidemiology 7(6):612–618PubMedCrossRef Baron JA, Karagas M, Barrett J et al (1996) Basic epidemiology of fractures of the upper and lower limb among Americans over 65 years of age. Epidemiology 7(6):612–618PubMedCrossRef
29.
Zurück zum Zitat Karagas MR, Baron JA, Barrett JA, Jacobsen SJ (1996) Patterns of fracture among the United States elderly: geographic and fluoride effects. Ann Epidemiol 6(3):209–216PubMedCrossRef Karagas MR, Baron JA, Barrett JA, Jacobsen SJ (1996) Patterns of fracture among the United States elderly: geographic and fluoride effects. Ann Epidemiol 6(3):209–216PubMedCrossRef
30.
Zurück zum Zitat Fisher ES, Baron JA, Malenka DJ, Barrett J, Bubolz TA (1990) Overcoming potential pitfalls in the use of Medicare data for epidemiologic research. Am J Public Health 80(12):1487–1490PubMed Fisher ES, Baron JA, Malenka DJ, Barrett J, Bubolz TA (1990) Overcoming potential pitfalls in the use of Medicare data for epidemiologic research. Am J Public Health 80(12):1487–1490PubMed
31.
Zurück zum Zitat Barrett JA, Baron JA, Karagas MR, Beach ML (1999) Fracture risk in the U.S. Medicare population. J Clin Epidemiol 52(3):243–249PubMedCrossRef Barrett JA, Baron JA, Karagas MR, Beach ML (1999) Fracture risk in the U.S. Medicare population. J Clin Epidemiol 52(3):243–249PubMedCrossRef
32.
Zurück zum Zitat Baron JA, Barrett JA, Karagas MR (1996) The epidemiology of peripheral fractures. Bone 18(3 Suppl):209S–213SPubMedCrossRef Baron JA, Barrett JA, Karagas MR (1996) The epidemiology of peripheral fractures. Bone 18(3 Suppl):209S–213SPubMedCrossRef
33.
Zurück zum Zitat Baron JA, Barrett J, Malenka D et al (1994) Racial differences in fracture risk. Epidemiology 5(1):42–47PubMedCrossRef Baron JA, Barrett J, Malenka D et al (1994) Racial differences in fracture risk. Epidemiology 5(1):42–47PubMedCrossRef
34.
Zurück zum Zitat Levy AR, Bensimon DR, Mayo NE, Leighton HG (1998) Inclement weather and the risk of hip fracture. Epidemiology 9(2):172–177PubMedCrossRef Levy AR, Bensimon DR, Mayo NE, Leighton HG (1998) Inclement weather and the risk of hip fracture. Epidemiology 9(2):172–177PubMedCrossRef
35.
Zurück zum Zitat Pedrazzoni M, Alfano FS, Malvi C, Ostanello F, Passeri M (1993) Seasonal variation in the incidence of hip fractures in Emilia-Romagna and Parma. Bone 14(Suppl 1):S57–S63PubMedCrossRef Pedrazzoni M, Alfano FS, Malvi C, Ostanello F, Passeri M (1993) Seasonal variation in the incidence of hip fractures in Emilia-Romagna and Parma. Bone 14(Suppl 1):S57–S63PubMedCrossRef
36.
Zurück zum Zitat Holmberg S, Thorngren KG (1987) Statistical analysis of femoral neck fractures based on 3053 cases. Clin Orthop 218:32–41PubMed Holmberg S, Thorngren KG (1987) Statistical analysis of femoral neck fractures based on 3053 cases. Clin Orthop 218:32–41PubMed
37.
Zurück zum Zitat Parker MJ, Martin S (1994) Falls, hip fractures and the weather. Eur J Epidemiol 10(4):441–442PubMedCrossRef Parker MJ, Martin S (1994) Falls, hip fractures and the weather. Eur J Epidemiol 10(4):441–442PubMedCrossRef
38.
Zurück zum Zitat Jacobsen SJ, Goldberg J, Miles TP, Brody JA, Stiers W, Rimm AA (1990) Regional variation in the incidence of hip fracture. US white women aged 65 years and older. JAMA 264(4):500–502PubMedCrossRef Jacobsen SJ, Goldberg J, Miles TP, Brody JA, Stiers W, Rimm AA (1990) Regional variation in the incidence of hip fracture. US white women aged 65 years and older. JAMA 264(4):500–502PubMedCrossRef
39.
Zurück zum Zitat O’Loughlin JL, Robitaille Y, Boivin JF, Suissa S (1993) Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly. Am J Epidemiol 137(3):342–354PubMed O’Loughlin JL, Robitaille Y, Boivin JF, Suissa S (1993) Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly. Am J Epidemiol 137(3):342–354PubMed
40.
Zurück zum Zitat Vellas BJ, Wayne SJ, Garry PJ, Baumgartner RN (1998) A two-year longitudinal study of falls in 482 community-dwelling elderly adults. J Gerontol 53A:M264–M274 Vellas BJ, Wayne SJ, Garry PJ, Baumgartner RN (1998) A two-year longitudinal study of falls in 482 community-dwelling elderly adults. J Gerontol 53A:M264–M274
41.
Zurück zum Zitat Holick MF (1985) The photobiology of vitamin D and its consequences for humans. Ann N Y Acad Sci 453:1–13PubMedCrossRef Holick MF (1985) The photobiology of vitamin D and its consequences for humans. Ann N Y Acad Sci 453:1–13PubMedCrossRef
42.
Zurück zum Zitat Harris SS, Dawson-Hughes B (1998) Seasonal changes in plasma 25-hydroxyvitamin D concentrations of young American black and white women. Am J Clin Nutr 67(6):1232–1236PubMed Harris SS, Dawson-Hughes B (1998) Seasonal changes in plasma 25-hydroxyvitamin D concentrations of young American black and white women. Am J Clin Nutr 67(6):1232–1236PubMed
43.
Zurück zum Zitat Dawson-Hughes B, Harris SS, Krall EA, Dallal GE (1997) Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med 337(10):670–676PubMedCrossRef Dawson-Hughes B, Harris SS, Krall EA, Dallal GE (1997) Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med 337(10):670–676PubMedCrossRef
44.
Zurück zum Zitat Gordon CM, DePeter KC, Feldman HA, Grace E, Emans SJ (2004) Prevalence of vitamin D deficiency among healthy adolescents. Arch Pediatr Adolesc Med 158(6):531–537PubMedCrossRef Gordon CM, DePeter KC, Feldman HA, Grace E, Emans SJ (2004) Prevalence of vitamin D deficiency among healthy adolescents. Arch Pediatr Adolesc Med 158(6):531–537PubMedCrossRef
45.
Zurück zum Zitat Webb AR, Kline L, Holick MF (1988) Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab 67(2):373–378PubMedCrossRef Webb AR, Kline L, Holick MF (1988) Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab 67(2):373–378PubMedCrossRef
46.
Zurück zum Zitat Standing Committee on the Scientific Evaluation of Dietary Reference Intakes (1997) Dietary reference intakes: calcium, phosphorus, magnesium, vitamin D, and fluoride. National Academy Press, Washington, DC Standing Committee on the Scientific Evaluation of Dietary Reference Intakes (1997) Dietary reference intakes: calcium, phosphorus, magnesium, vitamin D, and fluoride. National Academy Press, Washington, DC
47.
Zurück zum Zitat Ray WA, Griffin MR, Fought RL, Adams ML (1992) Identification of fractures from computerized Medicare files. J Clin Epidemiol 45(7):703–714PubMedCrossRef Ray WA, Griffin MR, Fought RL, Adams ML (1992) Identification of fractures from computerized Medicare files. J Clin Epidemiol 45(7):703–714PubMedCrossRef
48.
Zurück zum Zitat Fisher ES, Whaley FS, Krushat WM et al (1992) The accuracy of Medicare’s hospital claims data: progress has been made, but problems remain. Am J Public Health 82(2):243–248PubMedCrossRef Fisher ES, Whaley FS, Krushat WM et al (1992) The accuracy of Medicare’s hospital claims data: progress has been made, but problems remain. Am J Public Health 82(2):243–248PubMedCrossRef
Metadaten
Titel
Effect of seasonality and weather on fracture risk in individuals 65 years and older
verfasst von
H. A. Bischoff-Ferrari
J. E. Orav
J. A. Barrett
J. A. Baron
Publikationsdatum
01.09.2007
Verlag
Springer-Verlag
Erschienen in
Osteoporosis International / Ausgabe 9/2007
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-007-0364-6

Weitere Artikel der Ausgabe 9/2007

Osteoporosis International 9/2007 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.