Abstract
Summary
Fracture rates were examined in residents newly admitted to nursing homes. The risk of a fracture was highest during the first months after admission and declined thereafter. This risk pattern was observed independently of fracture site, gender or degree of care need.
Introduction and hypothesis
Residents of nursing homes are a high-risk group for fractures. The aim of the study was to analyse fracture rates as a function of time from admission to nursing home.
Methods
Fractures of the upper limb, femur, pelvis and lower leg, time to first and subsequent fractures, age, gender and care needs at admission were measured in 93,424 women and men aged 65 years and over and newly admitted to nursing homes in Bavaria between 2001 and 2006.
Results
Fracture incidence was highest during the first months after admission to nursing homes and declined thereafter. This pattern was observed for all fracture sites, in women and men and in residents with different care needs. For example, fracture rates of the upper limb declined from 30.0 to 13.5/1,000 person-years in the first 9 months after admission and for all fracture sites from 135.3 to 69.4/1,000 person-years in a corresponding time period.
Conclusion
Newly admitted residents have the highest fracture risk. The pattern of risk is similar across all fractures, suggesting a generic causal pathway. Implementation of effective fracture prevention efforts should be a priority at the time of admission to nursing homes.
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Acknowledgements
We thank Regina Merk-Bäuml, Ralf Brum, Johannes Laws-Hofmann, Gerhard Dahlhoff, Otto Gieseke, Michaela Heil, Stefanie Dörfler and Markus Gindl from the Allgemeine Ortskrankenkasse (AOK) and Ulrich Rissmann from the Robert-Bosch-Hospital, Stuttgart for the admission to the data and for the support of our analyses.
Conflicts of interest
None.
Funding
The analysis was supported by a grant of the Forschungskolleg Geriatrie of the Robert-Bosch Foundation and by the Bundesministerium für Bildung und Forschung (Förderkennzeichen: 01EL0702, 01EL0717, 01EL0718).
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Rapp, K., Lamb, S.E., Klenk, J. et al. Fractures after nursing home admission: incidence and potential consequences. Osteoporos Int 20, 1775–1783 (2009). https://doi.org/10.1007/s00198-009-0852-y
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DOI: https://doi.org/10.1007/s00198-009-0852-y