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Health September 2012

Aid for Age

Death by Hip Fracture: Take Steps Now to Try to Avoid It

By Tait Trussell

This is a wake-up call that the first year after a hip fracture is a critical time for all women, but especially for younger women, age 65 to 69, who face a much higher death rate. The reason is that those who are younger have a lower risk of dying from other causes, whereas older women tend to die from a variety of other causes other than resulting from hip breaks.

You’ve probably heard that the odds are you will die within a year if you break your hip. There is good reason to believe it.

Up to 40 percent of the patients die in the first year following a hip fracture, according to the journal Injury. The risk of mortality in hip fracture patients is three times higher than from every other cause of death, according to research by the journal BioMed. More than 300,000 hip fractures a year are reported in the U.S., according to Medscape. And by 2050, six to eight million hip fractures will occur annually worldwide.

But some ways to prevent such a tragedy from happening do exist, as I will point out later.

Studies have indicated that the death rate increases within a year after the fracture, particularly in many older women. The state of the person’s health can influence the risk of death after a hip fracture, although there’s some difference of opinion on this matter.

Women who break a hip at age 65 or older face double the risk of death, according to Dr. Teresa Hillier, at Kaiser Permanente Center for Health Research, even if they are in excellent health. She said that “other factors, such as surgery and immobility lead to other complications that ultimately result in their death.” Women are at higher risk than men because they are more subject to osteoporosis.

Specific age makes an important difference. Fractures occurring between the ages of 65 and 69 years result in a much higher death risk within a year of a fracture compared to a lower risk in the 70- to 79-year-old category, and in octogenarians, if the older women are in excellent health otherwise.

“This is a wake-up call that the first year after a hip fracture is a critical time for all women, but especially for younger women, age 65 to 69, who face a much higher death rate. The reason is that those who are younger have a lower risk of dying from other causes, whereas older women tend to die from a variety of other causes other than resulting from hip breaks.

A new analysis published in the journal Injury indicated a blood test could reduce the risk of complications and death in the elderly who have broken a hip. The article said that even patients who don’t die within the first year following a break “usually are institutionalized or are unable to resume normal activities.” Fifteen studies were analyzed between 1999 and 2010, involving more than 8,500 patients. Subjects studied were generally women 60 and older. They were followed for periods as long as 730 days. The analysis focused on five common chemical biomarkers. A biomarker, or biological marker is, in general, a substance used as an indicator of a biological state.

Three of the biomarkers, including albumin, creatinine (a compound that’s excreted in the urine) and parathyroid hormone, assessed the kidney function. Hemoglobin, which indicate anemia, and total lymphocyte count, a measure of immune system function, also were examined.The analysis showed that patients with low hemoglobin, high creatinine) and low lymphocyte (a type of white blood cell) were at greater risk of dying from hip fracture complications The biomarkers indicated that these conditions of patients were reversible with diet and electrolytes.

So, there are treatments that possibly can guard against hip fracture dangers. Care in walking and including enough calcium in your diet to strengthen bones are obvious additional safeguards. So are balance exercises. The Mayo Clinic recommends several simple exercises. For instance, balance on one foot with the other foot raised behind, and standing on one foot with the other foot raised forward. Hold each position for 30 seconds, while steadying yourself against a wall or in some other way.

Tai Chi is a gentle form of Chinese exercise that can help with balance problems. Check with your local senior center to see if they offer classes. Or go online to “exercises to improve balance.” You’ll find plenty of advice.

 

Tait Trussell is an old guy and fourth-generation professional journalist who writes extensively about aging issues among a myriad of diverse topics.

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