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AJPH First Look, published online ahead of print May 30, 2006
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96/7/1210    most recent
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July 2006, Vol 96, No. 7 | American Journal of Public Health 1210-1218
© 2006 American Public Health Association
DOI: 10.2105/AJPH.2005.077479

RESEARCH AND PRACTICE

Hip Fracture Risk Among Community-Dwelling Elderly People in the United States: A Prospective Study of Physical, Cognitive, and Socioeconomic Indicators

Robin Taylor Wilson, PhD, Gary A. Chase, PhD, Elizabeth A. Chrischilles, PhD and Robert B. Wallace, MD, MS

Robin Taylor Wilson and Gary A. Chase are with the Divisions of Epidemiology and Biostatistics, Department of Health Evaluation Sciences, Pennsylvania State College of Medicine, and the Penn State Cancer Institute, Hershey. Elizabeth A. Chrischilles and Robert B. Wallace are with the Department of Epidemiology, University of Iowa College of Public Health, Iowa City.

Correspondence: Requests for reprints should be sent to Robin Taylor Wilson, Division of Epidemiology, Department of Health Evaluation Sciences, Pennsylvania State College of Medicine, 600 Centerview Dr, Suite 2200, Mail Code A210, Hershey, PA 17033-0855 (e-mail: rwilson{at}psu.edu).

Objectives. We determined risks of short-term (2-year) hip fracture in a nationally representative, prospective cohort of community-dwelling elderly people 70 years or older.

Methods. We used self-report data from 2 waves of the Asset and Health Dynamics Survey (n = 5630). Sample-weighted logistic regression analyses were conducted to determine risk of hip fracture in relation to several demographic, cognitive, physical, and socioeconomic indicators.

Results. During the 2-year study period, 102 participants reported a new hip fracture. Several indicators of physical functioning and cognitive status, including incorrect delayed word recall and inability to lift 10 lbs (4.5 kg), were significantly associated with hip fracture risk. In the final model, mobile home residents, individuals without Medicare part B insurance, and those without a high-school diploma were at more than a 2-fold risk of hip fracture. Educational level, physical functioning, and insurance status were the top 3 contributors to hip fracture risk.

Conclusions. In addition to functional status measures, health insurance status, educational level, and type of residence appear to be independent predictors of hip fracture.




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