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High rate of fractures for men in nursing homes
1Medical Service, Veterans Administration Medical Center, North Chicago, Illinois.
Insights
Nursing home residents experienced significantly higher fracture rates, particularly hip fractures, compared to the general population. Older age was a risk factor for fractures in this institutionalized group.
Area of Science:
- Gerontology
- Orthopedics
- Epidemiology
Background:
- Institutionalized elderly men, particularly those in nursing homes, face unique health challenges.
- Fracture history and risk factors require specific investigation within long-term care settings.
Purpose of the Study:
- To analyze the incidence and rates of institutional fractures in male nursing home residents.
- To compare fracture rates in this population to age-matched general populations.
Main Methods:
- Retrospective chart review of 153 men (age 48-96) in a VA nursing home.
- Recorded fractures diagnosed 1-5 years prior to August 1984.
- Calculated fracture rates per 100,000 patient years for hip, spine, and wrist.
Main Results:
- 24 of 153 men experienced fractures during the review period; 6 had multiple fractures.
- Fracture rates per 100,000 patient years: hip (2,564), spine (366), wrist (549), all sites (5,861).
- These rates were 5-11 times higher than in the general population; older age correlated with any fracture.
Conclusions:
- Male nursing home residents exhibit substantially elevated fracture rates compared to their community-dwelling peers.
- Hip, spine, and wrist fractures are significant concerns in this institutionalized demographic.
- Age is a notable risk factor for fractures among men residing in nursing homes.
Abstract:
We have analyzed the history of institutional fractures in 153 men, age 48 to 96, 86% white, who had resided in this VA nursing home for an average of 6.3 years as of August 1984. At that time, we reviewed their medical charts to record the numbers and sites of fractures which had been diagnosed during the preceding 1 to 5 years of nursing home residence, the duration of this period depending on the duration of institutionalization. Fractures during the period of nursing home residence under review had occurred in 24 of the 153 men; 6 residents had experienced two or more fractures. Fracture rates during institutionalization in hip, spine, and wrist were 2,564, 366, and 549/100,000 patient years, respectively. The incidence at all sites was 5,861/100,000 patient years. These rates were 5 to 11 times higher than the figures previously reported in the age-matched general population of white men in the United States, England, or Finland. The nursing home men who had experienced fractures at any site were significantly (nondirectional P less than 0.02) older than those who had not experienced any fracture. The hip fracture group, however, did not differ significantly (P greater than 0.05) in age from the no fracture group.