Swedish study finds modest benefit in preventing repeat fractures in elderly women
A 20-year Swedish study of 1,233 women aged 70-100 found that a primary care fracture prevention program reduced repeat fractures by 29%, though overall hip fracture rates remained unchanged. The finding suggests targeted interventions can lower the healthcare costs of recurrent injuries, though preventing initial fractures remains the greater challenge.
Originaltitel: Reduced Risk of Recurrent Fragility Fractures After a Primary Care-Based Fracture Prevention Intervention: A 20-Year Non-Randomized Controlled Follow-Up Study in Women Aged 70-100
<p>Background: In Sweden 70,000 people suffer fragility fractures annually, including 16,000 hip fractures with one-year mortality of up to 25%. Strategies to prevent falls, improve physical function, and enhance bone strength have shown mixed results. Aim: To evaluate the incidence of hip and other fragility fractures following a fracture prevention intervention and assess baseline risk factors for long-term fracture outcomes. Methods: 1,233 rural Swedish women aged 70-100 years in 2002 were followed until 2021 after a primary care-based, non-randomized graded fracture prevention intervention 2002-2004 that included physical activity, fall prevention, and pharmacological treatment tailored to hip fracture risk. Fractures were identified through radiology reports 2002-2021. Results: The most common fractures occurred in the hip with 236 women sustaining 268 hip fractures with highest incidence in women aged 90-94 years. One-year hip fracture mortality was 27%. Hip fractures occurred in 17.7% of the intervention group (77/434) and 19.9% of controls (159/799, p = 0.36). Repeated fragility fractures occurred in 14.1% of the intervention group and 18.6% of controls (OR 0.71; 95% CI 0.53-1.0, p = 0.047), particularly when one fracture involved the hip (OR 0.54 (95% CI 0.31-0.95), p = 0.037). Increasing age (HR 1.8-4.0), height &gt;167 cm (HR 1.6; 95% CI 1.1-2.2), and weight &lt;60 kg (HR 1.5; 95% CI 1.1-2.0) were significant baseline risk factors. Conclusions: We noticed a non-significant reduction in hip fractures after 20 years, yet repeated fractures were less frequent in the intervention group suggesting a potential long-term benefit. Older, taller and lighter women were at greater risk for hip fracture.</p>