Osteoporosis, bone & mineral

Educational gradient in hip fracture incidence in Norway. The Norwegian Epidemiologic Osteoporosis Studies (NOREPOS)

Osteoporos IntPublished Population-based cohort study

Authors' conclusion

There was a clear educational gradient in hip fracture incidence in both men and women in Norway, with a higher risk in people with lower education. Despite this, the cumulative incidence of hip fracture in old age was highest among people with higher education, due to their higher life expectancy.

Study context

Population
Norwegians aged ≥ 50 years, education from Statistics Norway linked to hospital-treated hip fractures and deaths, 2002–2019135,938 incident hip fractures
Participants
1,389,858 participants
Exposure
Primary or secondary vs tertiary education, by gender
Outcome
Hip fracture risk by educational level
Methodological detailspopulation-wide, Cox proportional hazards regression, competing risk regression
  • Population-wide
  • Cox proportional hazards regression
  • Competing risk regression

Main finding

As reported in the abstract

Hip fracture, men
Each group vs tertiaryHazard ratio (95% CI)
Primarymen
1.44(1.40–1.49)
Secondarymen
1.26(1.22–1.29)
Primarywomen
1.28(1.25–1.31)
Secondarywomen
1.16(1.13–1.19)

Observational data: associations, not effects.

Further findings

Cumulative incidence of hip fracture over attained age

Highest in those with primary education in the age range 50 to 90 years
Gradient diminished with advancing age and reversed in the oldest (> 90 years) in both genders

Original publication

Educational gradient in hip fracture incidence in Norway. The Norwegian Epidemiologic Osteoporosis Studies (NOREPOS). Osteoporos Int. Published 25 June 2024. doi:10.1007/s00198-024-07133-1

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