Hip Fracture as a Predictive Marker for the Risk of Dementia: A Population-Based Cohort Study

Warrington W Q Hsu; Xiaowen Zhang; Chor-Wing Sing; Gloria H Y Li; Kathryn C B Tan; Annie W C Kung; Janus S H Wong; Ian Chi-Kei Wong; Ching-Lung Cheung

doi:10.1016/j.jamda.2022.07.013

Hip Fracture as a Predictive Marker for the Risk of Dementia: A Population-Based Cohort Study

J Am Med Dir Assoc. 2022 Oct;23(10):1720.e1-1720.e9. doi: 10.1016/j.jamda.2022.07.013. Epub 2022 Aug 18.

Authors

Warrington W Q Hsu¹, Xiaowen Zhang¹, Chor-Wing Sing², Gloria H Y Li³, Kathryn C B Tan⁴, Annie W C Kung⁴, Janus S H Wong⁵, Ian Chi-Kei Wong⁶, Ching-Lung Cheung⁷

Affiliations

¹ Department of Pharmacology and Pharmacy, University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China.
² Department of Pharmacology and Pharmacy, University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China; Laboratory of Data Discovery for Health Limited (D24H), Hong Kong Science Park, Hong Kong Special Administrative Region, China.
³ Department of Health Technology and Informatics, Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China.
⁴ Department of Medicine, University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China.
⁵ Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China.
⁶ Department of Pharmacology and Pharmacy, University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China; Laboratory of Data Discovery for Health Limited (D24H), Hong Kong Science Park, Hong Kong Special Administrative Region, China; Research Department of Practice and Policy, School of Pharmacy, University College London, London, United Kingdom.
⁷ Department of Pharmacology and Pharmacy, University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China; Laboratory of Data Discovery for Health Limited (D24H), Hong Kong Science Park, Hong Kong Special Administrative Region, China. Electronic address: lung1212@hku.hk.

PMID: 35988591
DOI: 10.1016/j.jamda.2022.07.013

Abstract

Objectives: This study aimed to investigate the association between hip fracture and the risk of dementia.

Design: A retrospective real-world propensity score-matched cohort study was conducted using the real-world hip fracture cohort (RHFC).

Setting and participants: Electronic health record data from the Clinical Data Analysis and Reporting System (CDARS) in Hong Kong were used. A total of 52,848 patients aged ≥65 years and with at least an event of fall from 2006 to 2015 were included in the RHFC.

Methods: The incidence of fall, hip fracture, and dementia was determined using their International Classification of Diseases, Ninth Revision (ICD-9) codes. Competing risk regression models were used to estimate hazard ratios (HRs) and 95% CIs.

Results: Hip fracture was associated with an increased risk of dementia (HR 1.09, 95% CI 1.04-1.15, P < .001). The subgroup analysis showed that association was significant in women but not in men.

Conclusions and implications: Hip fracture was associated with the increased risk of dementia among older adults. Further studies investigating the potential roles of hip fracture in the development of dementia could benefit the management of both conditions in older adults.

Keywords: Epidemiology; dementia; hip fracture; osteoporosis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cohort Studies
Dementia* / complications
Dementia* / epidemiology
Female
Hip Fractures* / epidemiology
Hip Fractures* / etiology
Humans
Incidence
Male
Retrospective Studies
Risk Factors