Risk Factors for Hip Fracture in Older Home Care Clients

TitleRisk Factors for Hip Fracture in Older Home Care Clients
Publication TypeJournal Article
Year of Publication2009
AuthorsStolee P, Poss J, Cook RJ, Byrne K, Hirdes JP
JournalJ Gerontol A Biol Sci Med Sci
Date PublishedMarch 1, 2009
Accession NumberWOS:000264190500011

BackgroundLittle information is available on hip fracture risks among community-dwelling persons receiving home care. Our aim was to identify risk factors for hip fracture from health information routinely collected for older home care clients. MethodsThis was a cohort study involving secondary analysis of data on 40,279 long-stay (>60 days) home care clients aged 65 and older in Ontario, Canada; occurrence of hip fracture as well as potential risk factor information were measured using the Resident Assessment Instrument (RAI)/Minimum Data Set-Home Care assessment instrument. ResultsIn all, 1,003 clients (2.5%) had hip fracture on follow-up assessment. Older (85+ vs 65-74, relative risk [95% confidence interval]: 0.52 [0.43-0.64]) clients are at increased risk; males are at reduced risk [0.60 (0.51-0.70)]. Other risk factors include osteoporosis (1.19 [1.03-1.36]), falls (1.31 [1.15-1.49]), unsteady gait (1.18 [1.03-1.36]), use of ambulation aide (1.39 [1.21-1.59]), tobacco use (1.42, [1.13-1.80]), severe malnutrition (2.61 [1.67-4.08]), and cognitive impairment (1.30 [1.12-1.51]). Arthritis (0.86 [0.76-0.98]) and morbid obesity (0.34 [0.16-0.72]) were associated with reduced risk. Males and females demonstrated different risk profiles. ConclusionsImportant risk factors for hip fracture can be identified from routinely collected data; these could be used to identify at-risk clients for further investigation and prevention strategies [22].