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Reduced Risk of Recurrent Fragility Fractures After a Primary Care–Based Fracture Prevention Intervention : A 20-Year Non-Randomized Controlled Follow-Up Study in Women Aged 70–100

Sjölander, Moses ; Alvunger, Lisa ; Eggertsen, Robert ; Lindgren, Anna LU ; Mölstad, Ulrica ; Petrazzuoli, Ferdinando LU orcid ; Segernäs, Anna ; Thulesius, Hans LU orcid ; Wanby, Pär LU and Albertsson, Daniel (2025) In Scandinavian Journal of Primary Health Care
Abstract

Background: In Sweden 70,000 people suffer fragility fractures annually, including 16,000 hip fractures with one-year mortality of up to 25%. Strategies to prevent falls, improve physical function, and enhance bone strength have shown mixed results. Aim: To evaluate the incidence of hip and other fragility fractures following a fracture prevention intervention and assess baseline risk factors for long-term fracture outcomes. Methods: 1,233 rural Swedish women aged 70–100 years in 2002 were followed until 2021 after a primary care-based, non-randomized graded fracture prevention intervention 2002–2004 that included physical activity, fall prevention, and pharmacological treatment tailored to hip fracture risk. Fractures were identified... (More)

Background: In Sweden 70,000 people suffer fragility fractures annually, including 16,000 hip fractures with one-year mortality of up to 25%. Strategies to prevent falls, improve physical function, and enhance bone strength have shown mixed results. Aim: To evaluate the incidence of hip and other fragility fractures following a fracture prevention intervention and assess baseline risk factors for long-term fracture outcomes. Methods: 1,233 rural Swedish women aged 70–100 years in 2002 were followed until 2021 after a primary care-based, non-randomized graded fracture prevention intervention 2002–2004 that included physical activity, fall prevention, and pharmacological treatment tailored to hip fracture risk. Fractures were identified through radiology reports 2002–2021. Results: The most common fractures occurred in the hip with 236 women sustaining 268 hip fractures with highest incidence in women aged 90–94 years. One-year hip fracture mortality was 27%. Hip fractures occurred in 17.7% of the intervention group (77/434) and 19.9% of controls (159/799, p = 0.36). Repeated fragility fractures occurred in 14.1% of the intervention group and 18.6% of controls (OR 0.71; 95% CI 0.53–1.0, p = 0.047), particularly when one fracture involved the hip (OR 0.54 (95% CI 0.31–0.95), p = 0.037). Increasing age (HR 1.8–4.0), height >167 cm (HR 1.6; 95% CI 1.1–2.2), and weight <60 kg (HR 1.5; 95% CI 1.1–2.0) were significant baseline risk factors. Conclusions: We noticed a non-significant reduction in hip fractures after 20 years, yet repeated fractures were less frequent in the intervention group suggesting a potential long-term benefit. Older, taller and lighter women were at greater risk for hip fracture.

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; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
fracture prevention, fragility fractures, hip fractures, longitudinal studies, osteoporosis, Primary health care, risk factors
in
Scandinavian Journal of Primary Health Care
publisher
Informa Healthcare
external identifiers
  • scopus:105021265307
ISSN
0281-3432
DOI
10.1080/02813432.2025.2571929
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
id
0cd098f2-4dd2-425a-9953-0a4ce968b081
date added to LUP
2026-01-12 09:49:47
date last changed
2026-01-12 13:29:26
@article{0cd098f2-4dd2-425a-9953-0a4ce968b081,
  abstract     = {{<p>Background: In Sweden 70,000 people suffer fragility fractures annually, including 16,000 hip fractures with one-year mortality of up to 25%. Strategies to prevent falls, improve physical function, and enhance bone strength have shown mixed results. Aim: To evaluate the incidence of hip and other fragility fractures following a fracture prevention intervention and assess baseline risk factors for long-term fracture outcomes. Methods: 1,233 rural Swedish women aged 70–100 years in 2002 were followed until 2021 after a primary care-based, non-randomized graded fracture prevention intervention 2002–2004 that included physical activity, fall prevention, and pharmacological treatment tailored to hip fracture risk. Fractures were identified through radiology reports 2002–2021. Results: The most common fractures occurred in the hip with 236 women sustaining 268 hip fractures with highest incidence in women aged 90–94 years. One-year hip fracture mortality was 27%. Hip fractures occurred in 17.7% of the intervention group (77/434) and 19.9% of controls (159/799, p = 0.36). Repeated fragility fractures occurred in 14.1% of the intervention group and 18.6% of controls (OR 0.71; 95% CI 0.53–1.0, p = 0.047), particularly when one fracture involved the hip (OR 0.54 (95% CI 0.31–0.95), p = 0.037). Increasing age (HR 1.8–4.0), height &gt;167 cm (HR 1.6; 95% CI 1.1–2.2), and weight &lt;60 kg (HR 1.5; 95% CI 1.1–2.0) were significant baseline risk factors. Conclusions: We noticed a non-significant reduction in hip fractures after 20 years, yet repeated fractures were less frequent in the intervention group suggesting a potential long-term benefit. Older, taller and lighter women were at greater risk for hip fracture.</p>}},
  author       = {{Sjölander, Moses and Alvunger, Lisa and Eggertsen, Robert and Lindgren, Anna and Mölstad, Ulrica and Petrazzuoli, Ferdinando and Segernäs, Anna and Thulesius, Hans and Wanby, Pär and Albertsson, Daniel}},
  issn         = {{0281-3432}},
  keywords     = {{fracture prevention; fragility fractures; hip fractures; longitudinal studies; osteoporosis; Primary health care; risk factors}},
  language     = {{eng}},
  publisher    = {{Informa Healthcare}},
  series       = {{Scandinavian Journal of Primary Health Care}},
  title        = {{Reduced Risk of Recurrent Fragility Fractures After a Primary Care–Based Fracture Prevention Intervention : A 20-Year Non-Randomized Controlled Follow-Up Study in Women Aged 70–100}},
  url          = {{http://dx.doi.org/10.1080/02813432.2025.2571929}},
  doi          = {{10.1080/02813432.2025.2571929}},
  year         = {{2025}},
}