| dc.creator | Alves, Sandra Maria Ferreira | |
| dc.creator | Castiglione, D. | |
| dc.creator | Oliveira, C. Maria | |
| dc.creator | Sousa, B. | |
| dc.creator | Pina, M. Fátima | |
| dc.date | 2014-12-22T17:06:41Z | |
| dc.date | 2014-12-22T17:06:41Z | |
| dc.date | 2014 | |
| dc.date.accessioned | 2023-09-26T20:25:42Z | |
| dc.date.available | 2023-09-26T20:25:42Z | |
| dc.identifier | ALVES, S. MARIA; et al. Age-period-cohort effects in the incidence of hip fractures: political and economic events are coincident with changes in risk. Osteoporosis International, v.25, n.2, p. 711-720,2014. | |
| dc.identifier | 0937941X | |
| dc.identifier | https://www.arca.fiocruz.br/handle/icict/9279 | |
| dc.identifier | DOI:10.1007/s00198-013-2483-6 | |
| dc.identifier.uri | https://repositorioslatinoamericanos.uchile.cl/handle/2250/8856673 | |
| dc.description | Summary An age–period cohort model was fitted to analyse
time effects on hip fracture incidence rates by sex (Portugal,
2000–2008). Rates increased exponentially with age (age
effect). Incidence rates decreased after 2004 for women and
were random for men (period effect). New but comprehensive
fluctuations in risk were coincident with major political/
economic changes (cohort effect).
Introduction Healthcare improvements have allowed prevention
but have also increased life expectancy, resulting in more
people being at risk. Our aim was to analyse the separate
effects of age, period and cohort on incidence rates by sex in
Portugal, 2000–2008.
Methods From the National Hospital Discharge Register, we
selected admissions (aged ≥49 years) with hip fractures (ICD9-
CM, codes 820.x) caused by low/moderate trauma (falls from
standing height or less), readmissions and bone cancer cases. We
calculated person-years at risk using population data from
Statistics Portugal. To identify period and cohort effects for all
ages, we used an age–period–cohort model (1-year intervals)
followed by generalised additive models with a
negative binomial distribution of the observed incidence rates
of hip fractures.
Results There were 77,083 hospital admissions (77.4 % women).
Incidence rates increased exponentially with age for both sexes
(age effect). Incidence rates fell after 2004 for women and were
random for men (period effect). There was a general cohort effect
similar in both sexes; risk of hip fracture altered from an increasing
trend for those born before 1930 to a decreasing trend
following that year. Risk alterations (not statistically significant)
coincident with major political and economic change in the
history of Portugal were observed around birth cohorts 1920
(stable–increasing), 1940 (decreasing–increasing) and 1950 (increasing–decreasing
only among women).
Conclusions Hip fracture risk was higher for those born during
major economically/politically unstable periods. Although
bone quality reflects lifetime exposure, conditions at birth may
determine future risk for hip fractures. | |
| dc.format | application/pdf | |
| dc.language | eng | |
| dc.rights | open access | |
| dc.subject | Age–period–cohort | |
| dc.subject | Hip fractures | |
| dc.subject | Osteoporosis | |
| dc.subject | Population-based study | |
| dc.subject | Time trend | |
| dc.title | Age-period-cohort effects in the incidence of hip fractures: political and economic events are coincident with changes in risk | |
| dc.type | Article | |
