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Is the Swedish FRAX model appropriate for Swedish immigrants?
H Johansson1,2, A Odén3, M Lorentzon4
1Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK. helena.johansson@mbox319.swipnet.se.
Summary
Hip fracture incidence is significantly lower in immigrants compared to native Swedes. Current fracture risk assessment tools like FRAX may overestimate risk for immigrants, suggesting country of origin-specific models could be more appropriate.
Area of Science:
- Gerontology
- Epidemiology
- Public Health
Background:
- Osteoporotic fracture incidence and mortality rates differ globally, necessitating country-specific fracture risk assessment tools (e.g., FRAX®).
- The applicability of a new country's fracture prediction model to immigrant populations remains unclear.
- This study aimed to compare hip fracture incidence between foreign-born and Swedish-born residents in Sweden.
Purpose of the Study:
- To investigate and compare hip fracture incidence rates in foreign-born versus Swedish-born individuals residing in Sweden.
- To evaluate the suitability of the Swedish FRAX® model for immigrant populations.
Main Methods:
- A population-based cohort study was conducted in Sweden from 1987 to 2002.
- Included were all individuals aged 50 years and older, comprising 2.8 million Swedish-born and 270,000 foreign-born participants.
- Hip fracture incidence was analyzed based on age, sex, and country of birth.
Main Results:
- A total of 239,842 hip fractures occurred in Swedish-born individuals and 12,563 in foreign-born individuals.
- Hip fracture incidence was consistently lower in immigrants, approximately half that of native Swedes, even after 40 years of residence.
- While incidence increased slightly with time post-immigration and with age/sex, it remained substantially lower than in the Swedish-born population.
Conclusions:
- Immigrants residing in Sweden exhibit a substantially lower incidence of hip fractures compared to the native-born population.
- The current Swedish FRAX® model likely overestimates fracture risk for foreign-born individuals living in Sweden.
- Country of origin-specific fracture risk models may offer a more accurate assessment for immigrant populations.
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