{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:17:46Z","timestamp":1791821866757,"version":"4.3.4"},"reference-count":39,"publisher":"BMJ","issue":"1","funder":[{"DOI":"10.13039\/501100000377","name":"Dunhill Medical Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000377","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,10,9]]},"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to estimate the association of frailty with incidence and mortality of fractures at different sites in people aged over 80 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>UK family practices from 2001 to 2014.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>265\u2009195 registered participants aged 80 years and older.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Frailty status classified into \u2018fit\u2019, \u2018mild\u2019, \u2018moderate\u2019 and \u2018severe\u2019 frailty. Fractures, classified into non-fragility and fragility, including fractures of femur, pelvis, shoulder and upper arm, and forearm\/wrist. Incidence of fracture, and mortality within 90 days and 1\u2009year, were estimated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 28\u2009643 fractures including: non-fragility fractures, 9101; femur, 12 501; pelvis, 2172; shoulder and upper arm, 4965; and forearm\/wrist, 6315. The incidence of each fracture type was higher in women and increased with frailty category (femur, severe frailty compared with \u2018fit\u2019, incidence rate ratio (IRR) 2.4, 95% CI 2.3 to 2.6). Fractures of the femur (95\u201399 years compared with 80\u201384 years, IRR 2.7, 95% CI 2.6 to 2.9) and pelvis (IRR 2.9, 95% CI 2.5 to 3.3) were strongly associated with age but non-fragility and forearm fractures were not. Mortality within 90 days was greatest for femur fracture (adjusted HR, compared with forearm fracture 4.3, 95% CI 3.7 to 5.1). Mortality was higher in men and increased with age (HR 5.3, 95% CI 4.3 to 6.5 in those over 100 years compared with 80\u201384 years) but was less strongly associated with frailty category. Similar associations with fractures were seen at 1-year mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The incidence of fractures at all sites was higher in women and strongly associated with advancing frailty status, while the risk of mortality after a fracture was greater in men and was associated with age rather than frailty category.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-018836","type":"journal-article","created":{"date-parts":[[2018,1,22]],"date-time":"2018-01-22T00:16:41Z","timestamp":1516580201000},"page":"e018836","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":68,"title":["Incidence and mortality of fractures by frailty level over 80 years of age: cohort study using UK electronic health 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