The relation between hip fracture and alzheimerʹs disease in the canadian national population health survey health institutions data, 1994–1995: A cross-sectional study

PURPOSE: The purpose of this study is to examine the relation between hip fractures and Alzheimerʹs disease in institutionalized men and women who participated in the 1994–1995 Canadian National Population Health Survey (NPHS). METHODS: Participants in the institutional component of NPHS were randomly chosen from selected health care institutions from all provinces in Canada. A questionnaire, which assessed health, demographic and socio-economic status, risk factors, medication use, and falls, was administered by an interviewer. Proxy respondents were sought for residents who were ill or incapacitated. Logistic regression was used to examine the association between hip fractures and Alzheimerʹs disease in 408 men and 1105 women greater-or-equal, slanted65 years. Models were examined with either hip fracture or Alzheimerʹs disease as the dependent variable. Covariates that were assessed included osteoporosis, age group, sex, medications, reported falls and comorbid conditions. RESULTS: All hip fractures reported in this survey were the result of a fall, however only 3.7% of falls resulted in a hip fracture. Those who had sustained a hip fracture were more likely to have Alzheimerʹs disease (OR 2.0, 95% CI 1.1–3.5), osteoporosis (OR 4.3, 95% CI 2.5–7.4) and heart disease (OR 2.4, 95% CI 1.1–5.0). Respondents who had Alzheimerʹs disease were more likely to have sustained a hip fracture (OR 2.1 95% CI 1.2–3.6), to have osteoporosis (OR 1.9, 95% CI 1.5–2.5), and to have fallen (OR 1.4, 95% CI 1.1–1.8) and were less likely to be taking anti-psychotic medication (OR 0.4, 95% CI 0.3–0.6) than those with no diagnosis of Alzheimerʹs disease. CONCLUSIONS: There is an association between Alzheimerʹs disease and hip fractures that is independent of other covariates in this representative sample of institutionalized elderly Canadians.