Reduced Risk of Recurrent Fragility Fractures After a Primary Care-Based Fracture Prevention Intervention: A 20-Year...

Area of Science:

• Gerontology and Public Health
• Bone Health and Osteoporosis Research
• Epidemiology of Fractures

Background:

• Fragility fractures, including 16,000 hip fractures annually in Sweden, carry a high mortality rate (up to 25% within one year).
• Current prevention strategies focusing on falls, physical function, and bone strength yield inconsistent outcomes.
• The study addresses the significant public health burden of fragility fractures in an aging population.

Purpose of the Study:

• To assess the long-term incidence of hip and other fragility fractures after a primary care-based intervention.
• To identify baseline risk factors associated with long-term fracture outcomes in older women.
• To evaluate the effectiveness of a multi-faceted fracture prevention program.

Main Methods:

• A cohort of 1,233 rural Swedish women (aged 70-100 years) was followed from 2002 to 2021.
• Participants received a primary care-based intervention (2002-2004) including physical activity, fall prevention, and tailored pharmacological treatment.
• Fracture data were collected via radiology reports, with statistical analysis of incidence and risk factors.

Main Results:

• Hip fractures were most common (268 cases in 236 women), with the highest incidence in women aged 90-94 years.
• One-year mortality following hip fracture was 27%.
• Repeated fragility fractures were significantly less frequent in the intervention group (14.1%) compared to controls (18.6%; OR 0.71, p=0.047), particularly hip fractures (OR 0.54, p=0.037).

Conclusions:

• The intervention demonstrated a potential long-term benefit by reducing repeated fragility fractures, despite a non-significant reduction in hip fractures over 20 years.
• Older age, height >167 cm, and weight <60 kg were identified as significant baseline risk factors for hip fracture.
• Targeted interventions and risk factor assessment are crucial for managing fragility fractures in older women.