Dementia as risk factor for severe bone fractures among the elderly

Falls among elderly represent an important public health concern due to its high incidence, health implications, and medical care costs. The study aims to assess the association between dementia and bone fracture risk after falls among the elderly. A case-control of 404 subjects aged 60 years old or more living in Rio de Janeiro, Brazil, was carried out. Cases and controls were matched by age, sex, and hospital. Data were collected using structured interviews. Elderly people who scored 2 or more points in the BOAS (Brazil Old Age Schedule) scale were considered as having dementia. Odds ratios (OR) adjusted for potential confoundings were calculated using conditional logistic regression. Falls occurred at the same frequency in the morning, afternoon and night, but they were less common at dawn. Among those who fell at home, 78% had dementia against 55% with no dementia. The crude OR for the association between dementia and severe bone fracture was 2.0 (95% CI: 1.23-3.25). After adjustment for confounders there was a small reduction in the strength of this association (OR=1.82; 1.03-3.23). Dementia elderly people showed a higher risk of falling and being hospitalized due to bone fracture. This stresses the importance of special care for those individuals to reduce the occurrence of these accidents.