nach oben

Erschienen in:

25.06.2021 | Review

Socio-economic inequalities in fragility fracture incidence: a systematic review and meta-analysis of 61 observational studies

verfasst von: G. Valentin, M.B. Ravn, E.K. Jensen, K. Friis, A. Bhimjiyani, Y. Ben-Shlomo, A. Hartley, C.P. Nielsen, B. Langdahl, C.L. Gregson

Erschienen in: Osteoporosis International | Ausgabe 12/2021

Einloggen, um Zugang zu erhalten

Abstract

Summary

Individuals with low socio-economic status (SES) have a more than 25% higher risk of fragility fractures than individuals with high SES. Body mass index and lifestyle appear to mediate the effect of SES on fracture risk. Strategies to prevent fractures should aim to reduce unhealthy behaviours through tackling structural inequalities.

Introduction

This systematic review and meta-analysis aimed to evaluate the impact of socio-economic status (SES) on fragility fracture risk.

Methods

Medline, Embase, and CINAHL databases were searched from inception to 28 April 2021 for studies reporting an association between SES and fragility fracture risk among individuals aged ≥50 years. Risk ratios (RR) were combined in meta-analyses using random restricted maximum likelihood models, for individual-based (education, income, occupation, cohabitation) and area-based (Index of Multiple Deprivation, area income) SES measures.

Results

A total of 61 studies from 26 different countries including more than 19 million individuals were included. Individual-based low SES was associated with an increased risk of fragility fracture (RR 1.27 [95% CI 1.12, 1.44]), whilst no clear association was seen when area-based measures were used (RR 1.08 [0.91, 1.30]). The strength of associations was influenced by the type and number of covariates included in statistical models: RR 2.69 [1.60, 4.53] for individual-based studies adjusting for age, sex and BMI, compared with RR 1.06 [0.92, 1.22] when also adjusted for health behaviours (smoking, alcohol, and physical activity). Overall, the quality of the evidence was moderate.

Conclusion

Our results show that low SES, measured at the individual level, is a risk factor for fragility fracture. Low BMI and unhealthy behaviours are important mediators of the effect of SES on fracture risk. Strategies to prevent fractures and reduce unhealthy behaviours should aim to tackle structural inequalities in society thereby reducing health inequalities in fragility fracture incidence.

Nur mit Berechtigung zugänglich

Woolf SH, Schoomaker H (2019) Life expectancy and mortality rates in the United States, 1959-2017. Jama 322(20):1996–2016CrossRef

Morrison MMJATBPGJ (2020) Health equity in England: the Marmot review 10 years on. Institute of Health Equity, London

Nations U (2015) 17 UN Sustainable Development Goals

Pickett KE, Wilkinson RG (2015) Income inequality and health: a causal review. Soc Sci Med 128:316–326CrossRef

Marmot MG (2003) Understanding social inequalities in health. Perspect Biol Med 46(3 Suppl):S9–S23CrossRef

Valentin G, Pedersen SE, Christensen R, Friis K, Nielsen CP, Bhimjiyani A, Gregson CL, Langdahl BL (2020) Socio-economic inequalities in fragility fracture outcomes: a systematic review and meta-analysis of prognostic observational studies. Osteoporos Int 31(1):31–42. https://doi.org/10.1007/s00198-019-05143-yCrossRefPubMed

Petit M, Bryere J, Maravic M, Pallaro F, Marcelli C (2017) Hip fracture incidence and social deprivation: results from a French ecological study. Osteoporos Int 28(7):2045–2051. https://doi.org/10.1007/s00198-017-3998-zCrossRef

Vestergaard P, Rejnmark L, Mosekilde L (2006) Socioeconomic aspects of fractures within universal public healthcare: a nationwide case-control study from Denmark. Scand J Public Health 34(4):371–377. https://doi.org/10.1080/14034940500441223CrossRefPubMed

Brennan SL, Yan L, Lix LM, Morin SN, Majumdar SR, Leslie WD (2015) Sex- and age-specific associations between income and incident major osteoporotic fractures in Canadian men and women: a population-based analysis. Osteoporos Int 26(1):59–65. https://doi.org/10.1007/s00198-014-2914-zCrossRefPubMed

10.

Bhimjiyani A, Neuburger J, Jones T, Ben-Shlomo Y, Gregson CL (2018) The effect of social deprivation on hip fracture incidence in England has not changed over 14 years: an analysis of the English Hospital Episodes Statistics (2001-2015). Osteoporos Int 29(1):115–124. https://doi.org/10.1007/s00198-017-4238-2CrossRefPubMed

11.

Kanis J, Oden A, Johnell O, Jonsson B, De Laet C, Dawson A (2001) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int 12(5):417–427CrossRef

12.

Kanis J, McCloskey E, Johansson H, Oden A, Ström O, Borgström F (2010) Development and use of FRAX® in osteoporosis. Osteoporos Int 21(2):407–413CrossRef

13.

Droomers M, Schrijvers CT, Mackenbach JP (2001) Educational level and decreases in leisure time physical activity: predictors from the longitudinal GLOBE study. J Epidemiol Community Health 55(8):562–568. https://doi.org/10.1136/jech.55.8.562CrossRefPubMedPubMedCentral

14.

Droomers M, Schrijvers CT, Mackenbach JP (2004) Educational differences in starting excessive alcohol consumption: explanations from the longitudinal GLOBE study. Soc Sci Med 58(10):2023–2033. https://doi.org/10.1016/S0277-9536(03)00411-8CrossRefPubMed

15.

Stronks K, van de Mheen HD, Looman CW, Mackenbach JP (1997) Cultural, material, and psychosocial correlates of the socioeconomic gradient in smoking behavior among adults. Prev Med 26(5 Pt 1):754–766. https://doi.org/10.1006/pmed.1997.0174CrossRefPubMed

16.

De Laet C, Kanis J, Odén A, Johanson H, Johnell O, Delmas P, Eisman J, Kroger H, Fujiwara S, Garnero P (2005) Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 16(11):1330–1338CrossRef

17.

Xiang B-Y, Huang W, Zhou G-Q, Hu N, Chen H, Chen C (2017) Body mass index and the risk of low bone mass–related fractures in women compared with men: a PRISMA-compliant meta-analysis of prospective cohort studies. Medicine 96(12):e5290CrossRef

18.

Gonnelli S, Caffarelli C, Nuti R (2014) Obesity and fracture risk. Clinical Cases in Mineral and Bone Metabolism 11(1):9–14PubMedPubMedCentral

19.

Cohen AK, Rai M, Rehkopf DH, Abrams B (2013) Educational attainment and obesity: a systematic review. Obes Rev 14(12):989–1005. https://doi.org/10.1111/obr.12062CrossRefPubMedPubMedCentral

20.

Brennan SL, Pasco JA, Urquhart DM, Oldenburg B, Hanna F, Wluka AE (2009) The association between socioeconomic status and osteoporotic fracture in population-based adults: a systematic review. Osteoporos Int 20(9):1487–1497CrossRef

21.

Kristensen P, Thillemann T, Pedersen A, Søballe K, Johnsen S (2017) Socioeconomic inequality in clinical outcome among hip fracture patients: a nationwide cohort study. Osteoporos Int 28(4):1233–1243CrossRef

22.

Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol 62(10):e1–e34CrossRef

23.

Lundqvist A, Andersson E, Ahlberg I, Nilbert M, Gerdtham U (2016) Socioeconomic inequalities in breast cancer incidence and mortality in Europe—a systematic review and meta-analysis. The European Journal of Public Health 26(5):804–813CrossRef

24.

Huguet A, Hayden JA, Stinson J, McGrath PJ, Chambers CT, Tougas ME, Wozney L (2013) Judging the quality of evidence in reviews of prognostic factor research: adapting the GRADE framework. Syst Rev 2:71. https://doi.org/10.1186/2046-4053-2-71CrossRefPubMedPubMedCentral

25.

Hayden JA, Cote P, Steenstra IA, Bombardier C, Group Q-LW (2008) Identifying phases of investigation helps planning, appraising, and applying the results of explanatory prognosis studies. J Clin Epidemiol 61(6):552–560. https://doi.org/10.1016/j.jclinepi.2007.08.005CrossRefPubMed

26.

Hayden JA, van der Windt DA, Cartwright JL, Cote P, Bombardier C (2013) Assessing bias in studies of prognostic factors. Ann Intern Med 158(4):280–286. https://doi.org/10.7326/0003-4819-158-4-201302190-00009CrossRefPubMed

27.

Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (2019) Cochrane handbook for systematic reviews of interventions. In. John Wiley & Sons,CrossRef

28.

Wolinsky FD, Bentler SE, Liu L, Obrizan M, Cook EA, Wright KB, Geweke JF, Chrischilles EA, Pavlik CE, Ohsfeldt RL, Jones MP, Richardson KK, Rosenthal GE, Wallace RB (2009) Recent hospitalization and the risk of hip fracture among older Americans. J Gerontol A Biol Sci Med Sci 64(2):249–255. https://doi.org/10.1093/gerona/gln027CrossRefPubMed

29.

Goldman S, Radomislensky I, Ziv A, Israel Trauma G, Peleg K (2018) The impact of neighborhood socioeconomic disparities on injury. Int J Public Health 63(7):855–863. https://doi.org/10.1007/s00038-018-1119-1CrossRefPubMed

30.

Langeard A, Pothier K, Chastan N, Marcelli C, Chavoix C, Bessot N (2019) Reduced gait and postural stability under challenging conditions in fallers with upper limb fracture. Aging Clin Exp Res 31(4):483–489. https://doi.org/10.1007/s40520-018-0992-zCrossRefPubMed

31.

Cano RP, Galan FG, Dilsen G (1993) Risk factors for hip fracture in Spanish and Turkish women. Bone 14:69–72CrossRef

32.

Allali F, Rostom S, Bennani L, Abouqal R, Hajjaj-Hassouni N (2010) Educational level and osteoporosis risk in postmenopausal Moroccan women: a classification tree analysis. Clin Rheumatol 29(11):1269–1275. https://doi.org/10.1007/s10067-010-1535-yCrossRefPubMed

33.

Al-Algawy AAH, Baiee HA, Hasan S, Jassim I, Razaq M, Kamel F, Ali A, Khudhair E (2019) Risk factors associated with hip fractures among adult people in Babylon City, Iraq. Open Access Maced J Med Sci 7(21):3608–3614. https://doi.org/10.3889/oamjms.2019.734CrossRefPubMedPubMedCentral

34.

Benetou V, Orfanos P, Feskanich D, Michaelsson K, Pettersson-Kymmer U, Ahmed LA, Peasey A, Wolk A, Brenner H, Bobak M, Wilsgaard T, Schottker B, Saum KU, Bellavia A, Grodstein F, Klinaki E, Valanou E, Papatesta EM, Boffetta P, Trichopoulou A (2015) Education, marital status, and risk of hip fractures in older men and women: the CHANCES project. Osteoporos Int 26(6):1733–1746. https://doi.org/10.1007/s00198-015-3054-9CrossRefPubMed

35.

Cauley JA, Wu L, Wampler NS, Barnhart JM, Allison M, Chen Z, Jackson R, Robbins J (2007) Clinical risk factors for fractures in multi-ethnic women: the Women's Health Initiative. J Bone Miner Res 22(11):1816–1826. https://doi.org/10.1359/jbmr.070713CrossRefPubMed

36.

Chen FP, Fu TS, Lin YC, Fan CM (2018) Risk factors and quality of life for the occurrence of hip fracture in postmenopausal women. Biom J 41(3):202–208. https://doi.org/10.1016/j.bj.2018.04.001CrossRef

37.

Colon-Emeric CS, Biggs DP, Schenck AP, Lyles KW (2003) Risk factors for hip fracture in skilled nursing facilities: who should be evaluated? Osteoporos Int 14(6):484–489. https://doi.org/10.1007/s00198-003-1384-5CrossRefPubMed

38.

Crandall CJ, Han W, Greendale GA, Seeman T, Tepper P, Thurston R, Karvonen-Gutierrez C, Karlamangla AS (2014) Socioeconomic status in relation to incident fracture risk in the Study of Women's Health Across the Nation. Osteoporos Int 25(4):1379–1388. https://doi.org/10.1007/s00198-013-2616-yCrossRefPubMedPubMedCentral

39.

Espino DV, Palmer RF, Miles TP, Mouton CP, Wood RC, Bayne NS, Markides KP (2000) Prevalence, incidence, and risk factors associated with hip fractures in community-dwelling older Mexican Americans: results of the Hispanic EPESE study. Establish Population for the Epidemiologic Study for the Elderly. J Am Geriatr Soc 48(10):1252–1260. https://doi.org/10.1111/j.1532-5415.2000.tb02598.xCrossRefPubMed

40.

Farahmand BY, Persson PG, Michaelsson K, Baron JA, Parker MG, Ljunghall S, Swedish Hip Fracture G (2000) Socioeconomic status, marital status and hip fracture risk: a population-based case-control study. Osteoporos Int 11(9):803–808. https://doi.org/10.1007/s001980070060CrossRefPubMed

41.

Fernandez-Ruiz M, Guerra-Vales JM, Trincado R, Medrano MJ, Benito-Leon J, Bermejo-Pareja F (2014) Hip fracture in three elderly populations of central Spain: data from the NEDICES study. Intern Emerg Med 9(1):33–41. https://doi.org/10.1007/s11739-011-0728-yCrossRefPubMed

42.

Holmberg T, Moller S, Rothmann MJ, Gram J, Herman AP, Brixen K, Tolstrup JS, Hoiberg M, Bech M, Rubin KH (2019) Socioeconomic status and risk of osteoporotic fractures and the use of DXA scans: data from the Danish population-based ROSE study. Osteoporos Int 30(2):343–353. https://doi.org/10.1007/s00198-018-4768-2CrossRefPubMed

43.

Johansson H, Hongslo Vala C, Oden A, Lorentzon M, McCloskey E, Kanis JA, Harvey NC, Ohlsson C, Stefan Lohmander L, Karrholm J, Mellstrom D (2018) Low risk for hip fracture and high risk for hip arthroplasty due to osteoarthritis among Swedish farmers. Osteoporos Int 29(3):741–749. https://doi.org/10.1007/s00198-017-4355-yCrossRefPubMedPubMedCentral

44.

Kauppi M, Heliovaara M, Impivaara O, Knekt P, Jula A (2011) Parity and risk of hip fracture in postmenopausal women. Osteoporos Int 22(6):1765–1771. https://doi.org/10.1007/s00198-010-1392-1CrossRefPubMed

45.

Ma CC, Burchfiel CM, Grove J, Fekedulegn D, Lu Y, Andrew ME, Willcox B, Masaki KH, Curb JD, Rodriguez BL (2011) Risk factors for fractures among Japanese-American men: the Honolulu Heart Program and Honolulu–Asia Aging Study. Arch Osteoporos 6(1-2):197–207CrossRef

46.

Meyer HE, Henriksen C, Falch JA, Pedersen JI, Tverdal A (1995) Risk factors for hip fracture in a high incidence area: a case-control study from Oslo, Norway. Osteoporos Int 5(4):239–246. https://doi.org/10.1007/BF01774013CrossRefPubMed

47.

Pluskiewicz W, Adamczyk P, Czekajlo A, Grzeszczak W, Drozdzowska B (2014) Influence of education, marital status, occupation, and the place of living on skeletal status, fracture prevalence, and the course and effectiveness of osteoporotic therapy in women in the RAC-OST-POL Study. J Bone Miner Metab 32(1):89–95. https://doi.org/10.1007/s00774-013-0471-8CrossRefPubMed

48.

Ren Y, Hu J, Lu B, Zhou W, Tan B (2019) Prevalence and risk factors of hip fracture in a middle-aged and older Chinese population. Bone 122:143–149. https://doi.org/10.1016/j.bone.2019.02.020CrossRefPubMed

49.

Rodrigues AM, Eusebio M, Santos MJ, Gouveia N, Tavares V, Coelho PS, Mendes JM, Branco JC, Canhao H (2018) The burden and undertreatment of fragility fractures among senior women. Arch Osteoporos 13(1):22. https://doi.org/10.1007/s11657-018-0430-zCrossRefPubMed

50.

Sanfelix-Gimeno G, Sanfelix-Genoves J, Hurtado I, Reig-Molla B, Peiro S (2013) Vertebral fracture risk factors in postmenopausal women over 50 in Valencia, Spain. A population-based cross-sectional study. Bone 52(1):393–399. https://doi.org/10.1016/j.bone.2012.10.022CrossRefPubMed

51.

Shin CS, Kim MJ, Shim SM, Kim JT, Yu SH, Koo BK, Cho HY, Choi HJ, Cho SW, Kim SW, Kim SY, Yang SO, Cho NH (2012) The prevalence and risk factors of vertebral fractures in Korea. J Bone Miner Metab 30(2):183–192. https://doi.org/10.1007/s00774-011-0300-xCrossRefPubMed

52.

Syddall HE, Evandrou M, Dennison EM, Cooper C, Sayer AA (2012) Social inequalities in osteoporosis and fracture among community-dwelling older men and women: findings from the Hertfordshire Cohort Study. Arch Osteoporos 7:37–48. https://doi.org/10.1007/s11657-012-0069-0CrossRefPubMedPubMedCentral

53.

Tsutsumimoto K, Doi T, Makizako H, Hotta R, Nakakubo S, Makino K, Suzuki T, Shimada H (2018) Cognitive frailty is associated with fall-related fracture among older people. J Nutr Health Aging 22(10):1216–1220CrossRef

54.

van Lenthe FJ, Avendano M, van Beeck EF, Mackenbach JP (2011) Childhood and adulthood socioeconomic position and the hospital-based incidence of hip fractures after 13 years of follow-up: the role of health behaviours. J Epidemiol Community Health 65(11):980–985. https://doi.org/10.1136/jech.2010.115782CrossRefPubMed

55.

Wang Y, Ding H, Wang X, Wei Z, Feng S (2019) Associated factors for osteoporosis and fracture in Chinese elderly. Med Sci Monit 25:5580–5588. https://doi.org/10.12659/MSM.914182CrossRefPubMedPubMedCentral

56.

Wändell P, Li X, Carlsson A, Sundquist J, Sundquist K (2021) Osteoporotic fractures among foreign-born individuals: a national Swedish study. Osteoporos Int 32(2):343–352CrossRef

57.

Xavier RM, Giarola IC, Ocampos GP, Plapler PG, de Camargo OP, de Rezende MU (2019) Profile of patients with osteoporotic fractures and factors that decrease prevention. Acta Ortop Bras 27(2):95–99. https://doi.org/10.1590/1413-785220192702214727CrossRefPubMedPubMedCentral

58.

Zacharopoulou G, Zacharopoulou V, Voudouri E, Leondiou L, Dermatis Z (2019) Socioeconomic and clinical risk factors of hip fracture among the elderly: a case-control study. Br J Healthc Manag 25(10):1–16CrossRef

59.

Zhang XJ, Zhu YB, Liu S, Chen W, Liu B, Zhang F, Lv HZ, Ji CN, Zhang XL, Zhang YZ (2019) Incidence of low-energy upper extremity fractures and the risk factors in Chinese people 50 years or older. Orthop Surg 11(2):304–310. https://doi.org/10.1111/os.12448CrossRefPubMedPubMedCentral

60.

Hansen L, Mathiesen AS, Vestergaard P, Ehlers LH, Petersen KD (2013) A health economic analysis of osteoporotic fractures: who carries the burden? Arch Osteoporos 8(1-2):126CrossRef

61.

Kim J, Jang SN, Lim JY (2019) Pre-existing disability and its risk of fragility hip fracture in older adults. Int J Environ Res Public Health 16(7). https://doi.org/10.3390/ijerph16071237

62.

Lin KB, Yang NP, Lee YH, Chan CL, Wu CH, Chen HC, Chang NT (2018) The incidence and factors of hip fractures and subsequent morbidity in Taiwan: an 11-year population-based cohort study. PLoS One 13(2):e0192388. https://doi.org/10.1371/journal.pone.0192388CrossRefPubMedPubMedCentral

63.

Navarro M, Sosa M, Saavedra P, Lainez P, Marrero M, Torres M, Medina C (2009) Poverty is a risk factor for osteoporotic fractures. Osteoporos Int 20(3):393–398CrossRef

64.

Navarro MC, Saavedra P, Jódar E, Gómez de Tejada MJ, Mirallave A, Sosa M (2013) Osteoporosis and metabolic syndrome according to socio-economic status, contribution of PTH, vitamin D and body weight: the Canarian Osteoporosis Poverty Study (COPS). Clin Endocrinol 78(5):681–686CrossRef

65.

Park SB, Kim J, Jeong JH, Lee JK, Chin DK, Chung CK, Lee SH, Lee JY (2016) Prevalence and incidence of osteoporosis and osteoporotic vertebral fracture in Korea: nationwide epidemiological study focusing on differences in socioeconomic status. Spine (Phila Pa 1976) 41(4):328–336. https://doi.org/10.1097/BRS.0000000000001291CrossRef

66.

Peel NM, McClure RJ, Hendrikz JK (2007) Psychosocial factors associated with fall-related hip fractures. Age Ageing 36(2):145–151. https://doi.org/10.1093/ageing/afl167CrossRefPubMed

67.

Suen LK (1998) Occupation and risk of hip fracture. J Public Health Med 20(4):428–433. https://doi.org/10.1093/oxfordjournals.pubmed.a024798CrossRefPubMed

68.

Trimpou P, Landin-Wilhelmsen K, Oden A, Rosengren A, Wilhelmsen L (2010) Male risk factors for hip fracture-a 30-year follow-up study in 7,495 men. Osteoporos Int 21(3):409–416. https://doi.org/10.1007/s00198-009-0961-7CrossRefPubMed

69.

Korpelainen R, Korpelainen J, Heikkinen J, Vaananen K, Keinanen-Kiukaanniemi S (2006) Lifelong risk factors for osteoporosis and fractures in elderly women with low body mass index--a population-based study. Bone 39(2):385–391. https://doi.org/10.1016/j.bone.2006.01.143CrossRefPubMed

70.

Lee KH, Kim JY, Yim SJ, Moon DH, Choi GH, Moon KH (2014) Incidence and risk factors of subsequent hip fractures in Korea: multicenter study. J Korean Med Sci 29(7):992–994. https://doi.org/10.3346/jkms.2014.29.7.992CrossRefPubMedPubMedCentral

71.

Reimers A, Laflamme L (2007) Hip fractures among the elderly: personal and contextual social factors that matter. J Trauma Acute Care Surg 62(2):365–369CrossRef

72.

Brennan SL, Winzenberg TM, Pasco JA, Wluka AE, Dobbins AG, Jones G (2013) Social disadvantage, bone mineral density and vertebral wedge deformities in the Tasmanian Older Adult Cohort. Osteoporos Int 24(6):1909–1916. https://doi.org/10.1007/s00198-012-2211-7CrossRefPubMed

73.

Cassell E, Clapperton A (2013) A decreasing trend in fall-related hip fracture incidence in Victoria, Australia. Osteoporos Int 24(1):99–109. https://doi.org/10.1007/s00198-012-1937-6CrossRefPubMed

74.

Curtis EM, van der Velde R, Moon RJ, van den Bergh JP, Geusens P, de Vries F, van Staa TP, Cooper C, Harvey NC (2016) Epidemiology of fractures in the United Kingdom 1988-2012: variation with age, sex, geography, ethnicity and socioeconomic status. Bone 87:19–26. https://doi.org/10.1016/j.bone.2016.03.006CrossRefPubMedPubMedCentral

75.

Jones S, Johansen A, Brennan J, Butler J, Lyons RA (2004) The effect of socioeconomic deprivation on fracture incidence in the United Kingdom. Osteoporos Int 15(7):520–524. https://doi.org/10.1007/s00198-003-1564-3CrossRefPubMed

76.

Maharlouei N, Khodayari M, Forouzan F, Rezaianzadeh A, Lankarani KB (2014) The incidence rate of hip fracture in Shiraz, Iran during 2008-2010. Arch Osteoporos 9:165. https://doi.org/10.1007/s11657-013-0165-9CrossRefPubMed

77.

Oliveira CM, Alves SM, Pina MF (2016) Marked socioeconomic inequalities in hip fracture incidence rates during the Bone and Joint Decade (2000-2010) in Portugal: age and sex temporal trends in a population based study. J Epidemiol Community Health 70(8):755–763. https://doi.org/10.1136/jech-2015-206508CrossRefPubMed

78.

Quah C, Boulton C, Moran C (2011) The influence of socioeconomic status on the incidence, outcome and mortality of fractures of the hip. J Bone Joint Surg (Br) 93(6):801–805. https://doi.org/10.1302/0301-620X.93B6.24936CrossRef

79.

Bacon WE, Hadden WC (2000) Occurrence of hip fractures and socioeconomic position. J Aging Health 12(2):193–203. https://doi.org/10.1177/089826430001200203CrossRefPubMed

80.

Brennan SL, Leslie WD, Lix LM, Johansson H, Oden A, McCloskey E, Kanis JA (2014) FRAX provides robust fracture prediction regardless of socioeconomic status. Osteoporos Int 25(1):61–69. https://doi.org/10.1007/s00198-013-2525-0CrossRefPubMed

81.

Guilley E, Herrmann F, Rapin CH, Hoffmeyer P, Rizzoli R, Chevalley T (2011) Socioeconomic and living conditions are determinants of hip fracture incidence and age occurrence among community-dwelling elderly. Osteoporos Int 22(2):647–653. https://doi.org/10.1007/s00198-010-1287-1CrossRefPubMed

82.

Taylor AJ, Gary LC, Arora T, Becker DJ, Curtis JR, Kilgore ML, Morrisey MA, Saag KG, Matthews R, Yun H, Smith W, Delzell E (2011) Clinical and demographic factors associated with fractures among older Americans. Osteoporos Int 22(4):1263–1274. https://doi.org/10.1007/s00198-010-1300-8CrossRefPubMed

83.

Zingmond DS, Soohoo NF, Silverman SL (2006) The role of socioeconomic status on hip fracture. Osteoporos Int 17(10):1562–1568. https://doi.org/10.1007/s00198-006-0161-7CrossRefPubMed

84.

Conway DI, McMahon AD, Brown D, Leyland AH (2019) Measuring socioeconomic status and inequalities. 150 cours Albert Thomas, 69372 Lyon Cedex 08, France© International Agency for Research on Cancer Distributed by WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland 71

85.

Osler M, McGue M, Lund R, Christensen K (2008) Marital status and twins’ health and behavior: an analysis of middle-aged Danish twins. Psychosom Med 70(4):482–487CrossRef

Titel: Socio-economic inequalities in fragility fracture incidence: a systematic review and meta-analysis of 61 observational studies
verfasst von: G. Valentin
M.B. Ravn
E.K. Jensen
K. Friis
A. Bhimjiyani
Y. Ben-Shlomo
A. Hartley
C.P. Nielsen
B. Langdahl
C.L. Gregson
Publikationsdatum: 25.06.2021
Verlag: Springer London
Erschienen in: Osteoporosis International / Ausgabe 12/2021
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-021-06038-7

Arthropedia

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

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

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

Newsletter bestellen

Springer Medizin

Abstract

Summary

Introduction

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 12/2021

Correction to: Factors associated with changes in volumetric bone mineral density and cortical area in men with ankylosing spondylitis: a 5-year prospective study using HRpQCT.

RE: Advanced 2D image processing technique to predict hip fracture risk in an older population based on single DXA scans

Diagnosis and management of osteoporosis in chronic kidney disease stages 4 to 5D: a call for a shift from nihilism to pragmatism

Comparison of fracture risk between type 1 and type 2 diabetes: a comprehensive real-world data

Trends and regional variation in vertebroplasty and kyphoplasty in Switzerland: a population-based small area analysis