A study published in the Lancet Public Health in 2017 examined the number of productive life years lost due to hip fractures among the elderly.
Fractures are an important cause of disability in the elderly. Due to decreased bone mass among this age group, fractures are more common and tend to have a profound effect on ability to perform activities of daily living. Many studies explore the mortality rates among people suffering from hip fractures. However, there are few studies assessing disability-adjusted life years (DALY) after suffering a hip fracture, or simply put, the number of productive years lost by person due to the disability.
In a recent study published in the Lancet Public Health, a group of researchers conducted an analysis of different prospective cohorts to examine the DALYs lost due to hip fractures. From a total of 6 cohorts, the researchers included 223,880 men and women over 50 years of age and followed them regularly for 13 years. Other factors taken into consideration were smoking status, body mass index (BMI), physical activity, alcohol intake, use of hormonal replacement therapy or oral contraceptives, diabetes mellitus type 2, and parity. DALY was computed using the combination of years lost due to premature mortality (YLL) and years of health life lost due to disability (YLD). YLL was computed by multiplying the number of deaths due to hip fracture by the expected life-years remaining at respected age of death. YLD was computed by multiplying number of hip fracture cases by the duration of disease and the disability weight (ranging from 0 for perfect health to 1 for death)
The results show that out of 7,724 incident cases of hip fractures, 413 deaths (5.3%) were identified. With regards to DALYs lost, a total of 5964 years (27 years per 1000 individuals) were lost, with 70% attributed to disability. More DALYs were observed to be lost in women compared to men, and to those belonging to older age groups. Years lost due to disability were greatest in people aged 70-74 years, while people aged 80-84 years lost the greatest number of YLLs. Smoking status, physical inactivity, history of diabetes mellitus 2, and low BMI contributed to a greater disease burden, while having high BMI and low alcohol consumption were observed to have a protective effect.
Overall, hip fractures contribute to significant loss in productive years among the elderly. Changing modifiable risk factors such as smoking and physical inactivity may help in reducing DALYs lost after hip fracture. Programs and measures which prevent the incidence of hip fractures among this age group may also help improve quality of life.
Written By: Karla Sevilla