Hip fracture in three elderly populations of central Spain: data from the NEDICES study

There is a paucity of data concerning the specific associations between hip fracture in the elderly and other age-related conditions, as well as its impact on long-term survival. This study was aimed to estimate the prevalence, risk factors, and outcome of self-reported hip fracture (srHF) in a cohort of Spanish elderly individuals. Neurological Disorders in Central Spain (NEDICES) is a census population-based survey of the prevalence and incidence of major age-associated conditions in three areas of central Spain. Data on health status and several chronic conditions were evaluated in the baseline questionnaire (1994-1995). Odds ratios for the association between srHF and other comorbidities and health-related variables were assessed by logistic regression. A Cox model estimated the impact of srHF on 13-year all-cause mortality. The final cohort comprised 5,278 community-living elderly subjects. A total of 166 participants (3.1%) had srHF. Prevalence was associated with higher age, female gender, degree of urbanisation of residence place, lower body mass index (BMI), higher number of chronic medications, higher Pfeffer FAQ score, being unmarried (P < 0.001 for all), and infantile living conditions (P = 0.007). Participants with srHF had a higher number of associated chronic conditions (P < 0.001). In the multivariate analysis, self-reported osteoporosis, lower BMI category, rural environment during childhood, and higher age were identified as independent risk factors for srHF. Adjusted hazard ratio for mortality in the srHF group was 1.40 (95% confidence interval 1.15-1.71; P = 0.001). srHF is a common condition among community-living elderly population in Spain, and has a significant impact upon long-term all-cause mortality.