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Predictors and Sequelae of Fractures in the Elderly: The Canadian Study of Health and Aging (CSHA)*

Published online by Cambridge University Press:  31 March 2010

Truls Østbye ,
Ruth E. Walton ,
Runa Steenhuis  and
Anthony B. Hodsman
Truls Østbye*
Affiliation:
Department of Community and Family Medicine, Duke University Medical Center
Ruth E. Walton
Affiliation:
Canadian Task Force on Preventive Health Care
Runa Steenhuis
Affiliation:
Short Stay Assessment and Treatment Centre, Mount St. Joseph Hospital, Vancouver
Anthony B. Hodsman
Affiliation:
Lawson Research Institute Faculty of Medicine, University of Western Ontario
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être adressées à : Truls Østbye, Department of Community and Family Medicine, Box 2914, Duke University Medical Center, Durham, NC 27710. ([email protected])
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Abstract

The objective of this study was to describe the incidence, type, risk factors, and sequelae of fractures experienced by community-dwelling elderly Canadians. Data are from the Canadian Study of Health and Aging (CSHA), a longitudinal cohort study, collected in three waves: baseline (1991), wave 2 (1996), and wave 3 (2001). In CSHA-2 (1996), fractures were reported by 3.7 per cent of men and 7.5 per cent of women; in CSHA-3 (2001), by 2.9 per cent of men and 7.3 per cent of women. The distribution of fracture types was similar for men and women. Risk factors for women were increased age, history of fracture, and regular alcohol use; for men, stroke, arthritis, and lack of independent bathing. Walkers or wheelchairs were needed by over 30 per cent of those with any lower body fracture. One third of subjects with any fracture and over 50 per cent with femur fractures reported moderate or severe pain. It is concluded that elderly Canadians are at high risk for fractures, and older women are at most risk. Pain and mobility problems were common sequelae. The need for primary and secondary prevention of these age-related events is paramount.

Résumé

Cette étude avait pour objet de décrire l'incidence, le type, les facteurs de risque et les séquelles laissées par les fractures chez les aînés canadiens vivant en milieu communautaire. Les données sont tirées de l'Étude sur la santé et le vieillissement au Canada (ÉSVC), une étude longitudinale des cohortes effectuée en trois phases : étude préliminaire (1991), phase 2 (1996) et phase 3 (2001). Dans l'ÉSVC-2 (1996), 3,7 % des hommes et 7,5 % des femmes sondés avaient subi une fracture, dans l'ÉSVC-3 (2001) ces chiffres étaient de 2,9 % pour les hommes et de 7,3 % pour les femmes. Les types de fractures étaient les mêmes chez les deux sexes. Chez les femmes, les facteurs de risque étaient l'âge, les antécédents de fracture et la consommation régulière d'alcool, et chez les hommes, les accidents vasculaires cérébraux, l'arthrite et la difficulté de faire sa toilette seul. Plus de 30 % des personnes ayant eu une fracture du tronc inférieur avaient besoin d'une marchette ou d'un fauteuil roulant pour se déplacer. Un tiers des sujets ayant eu une fracture et plus de la moitié de ceux qui s'étaient fracturé le fémur disaient souffrir de douleur modérée à forte. En conclusion, le risque de fracture chez les aînés canadiens est élevé, et les femmes sont plus à risque que les hommes. Les séquelles le plus souvent rapportées sont la douleur et des problèmes de mobilité. Il est essentiel de mettre en place des stratégies de prévention primaire et secondaire contre ces accidents liés à l'âge.

Keywords

agingfractureselderlypainsequelaerisk factorsCanadavieillissementfracturespersonnes âgées/aînésdouleurséquellesfacteurs de risqueCanada
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 23 , Issue 3 , Fall/Automne 2004 , pp. 245 - 251
Copyright
Copyright © Canadian Association on Gerontology 2004

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Footnotes

*

The data reported in this article were collected as part of the Canadian Study of Health and Aging. The core study was funded by the Seniors' Independence Research Program, through the National Health Research and Development Program (NHRDP) of Health Canada (project no. 6606–3954-MC(S)). Additional funding was provided by Pfizer Canada Incorporated through the Medical Research Council / Pharmaceutical Manufacturers Association of Canada Health Activity Program, NHRDP (project no. 6603–1417–302(R)), Bayer Incorporated, and the British Columbia Health Research Foundation (projects no. 38 (93–2) and no. 34 (96–1)). The study was coordinated through the University of Ottawa and the Division of Aging and Seniors, Health Canada. Thanks to Katrina Krause, M.A., for editing of the manuscript.

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