TY - JOUR
T1 - Education, marital status, and risk of hip fractures in older men and women
T2 - the CHANCES project
AU - Benetou, V.
AU - Orfanos, P.
AU - Feskanich, D.
AU - Michaëlsson, K.
AU - Pettersson-Kymmer, U.
AU - Ahmed, L. A.
AU - Peasey, A.
AU - Wolk, A.
AU - Brenner, H.
AU - Bobak, M.
AU - Wilsgaard, T.
AU - Schöttker, B.
AU - Saum, K. U.
AU - Bellavia, A.
AU - Grodstein, F.
AU - Klinaki, E.
AU - Valanou, E.
AU - Papatesta, E. M.
AU - Boffetta, P.
AU - Trichopoulou, A.
N1 - Funding Information:
This work, derived from the CHANCES project, was supported by the FP7 framework programme of DG-RESEARCH in the European Commission [Grant number: HEALTH-F3-2010-242244]. The project is coordinated by the Hellenic Health Foundation, Greece. The national cohorts are supported by (1) EPIC-Elderly Greece: the Hellenic Health Foundation; (2) EPIC-Elderly Umea, Sweden: the Swedish Cancer Society and the Swedish Research Council; (3) ESTHER, Germany: the Baden-Württemberg state Ministry of Science, Research and Arts (Stuttgart, Germany), the Federal Ministry of Education and Research (Berlin, Germany) and the Federal Ministry of Family Affairs, Senior Citizens, Women and Youth (Berlin, Germany); (4) the Tromsø study: UiT–The Arctic University of Norway, the National Screening Services, the Research Council of Norway, Northern Norway Regional Health Authority, the Norwegian Council on Cardiovascular Diseases, the Norwegian Foundation for Health and Rehabilitation, the Norwegian Diabetes Association, the Cancer Registry of Norway, the Odd Berg Group Research Fund, and Troms County Council; (5) COSM and SMC, Karolinska Institutet, Sweden: the Swedish Research Council Karolinska Institutet’s Strategic Foundation and Uppsala University, and the Swedish Cancer Society; (6) NHS: the National Cancer Institute [grant P01CA87969].
Publisher Copyright:
© 2015, International Osteoporosis Foundation and National Osteoporosis Foundation.
PY - 2015/6/17
Y1 - 2015/6/17
N2 - Summary: The role of socioeconomic status in hip fracture incidence is unclear. In a diverse population of elderly, higher education was found to be associated with lower, whereas living alone, compared to being married/cohabiting, with higher hip fracture risk. Educational level and marital status may contribute to hip fracture risk. Introduction: The evidence on the association between socioeconomic status and hip fracture incidence is limited and inconsistent. We investigated the potential association of education and marital status with hip fracture incidence in older individuals from Europe and USA. Methods: A total of 155,940 participants (79 % women) aged 60 years and older from seven cohorts were followed up accumulating 6456 incident hip fractures. Information on education and marital status was harmonized across cohorts. Hip fractures were ascertained through telephone interviews/questionnaires or through record linkage with registries. Associations were assessed through Cox proportional hazard regression adjusting for several factors. Summary estimates were derived using random effects models. Results: Individuals with higher education, compared to those with low education, had lower hip fracture risk [hazard ratio (HR) = 0.84, 95 % confidence interval (CI) 0.72–0.95]. Respective HRs were 0.97 (95 % CI 0.82–1.13) for men and 0.75 (95 % CI 0.65–0.85) for women. Overall, individuals living alone, especially those aged 60–69 years, compared to those being married/cohabiting, tended to have a higher hip fracture risk (HR = 1.12, 95 % CI 1.02–1.22). There was no suggestion for heterogeneity across cohorts (Pheterogeneity > 0.05). Conclusions: The combined data from >150,000 individuals 60 years and older suggest that higher education may contribute to lower hip fracture risk. Furthermore, this risk may be higher among individuals living alone, especially among the age group 60–69 years, when compared to those being married/cohabiting.
AB - Summary: The role of socioeconomic status in hip fracture incidence is unclear. In a diverse population of elderly, higher education was found to be associated with lower, whereas living alone, compared to being married/cohabiting, with higher hip fracture risk. Educational level and marital status may contribute to hip fracture risk. Introduction: The evidence on the association between socioeconomic status and hip fracture incidence is limited and inconsistent. We investigated the potential association of education and marital status with hip fracture incidence in older individuals from Europe and USA. Methods: A total of 155,940 participants (79 % women) aged 60 years and older from seven cohorts were followed up accumulating 6456 incident hip fractures. Information on education and marital status was harmonized across cohorts. Hip fractures were ascertained through telephone interviews/questionnaires or through record linkage with registries. Associations were assessed through Cox proportional hazard regression adjusting for several factors. Summary estimates were derived using random effects models. Results: Individuals with higher education, compared to those with low education, had lower hip fracture risk [hazard ratio (HR) = 0.84, 95 % confidence interval (CI) 0.72–0.95]. Respective HRs were 0.97 (95 % CI 0.82–1.13) for men and 0.75 (95 % CI 0.65–0.85) for women. Overall, individuals living alone, especially those aged 60–69 years, compared to those being married/cohabiting, tended to have a higher hip fracture risk (HR = 1.12, 95 % CI 1.02–1.22). There was no suggestion for heterogeneity across cohorts (Pheterogeneity > 0.05). Conclusions: The combined data from >150,000 individuals 60 years and older suggest that higher education may contribute to lower hip fracture risk. Furthermore, this risk may be higher among individuals living alone, especially among the age group 60–69 years, when compared to those being married/cohabiting.
KW - Education
KW - Elderly
KW - Fractures
KW - Hip fractures
KW - Marital status
KW - Socioeconomic status
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U2 - 10.1007/s00198-015-3054-9
DO - 10.1007/s00198-015-3054-9
M3 - Article
C2 - 25820745
AN - SCOPUS:84931004268
SN - 0937-941X
VL - 26
SP - 1733
EP - 1746
JO - Osteoporosis International
JF - Osteoporosis International
IS - 6
ER -