Are you at risk for a broken hip?

Can you squat over a toilet and hover over it without touching the seat? Can you kneel down and then get up off of the ground without using your arms?

If you answered NO to either of these questions, you are living in very dangerous waters.

In medicine we all know one thing: a hip fracture in the elderly is a near death sentence.

Most hips don’t fracture because of the fall. They were ALREADY fractured and they caused the fall.

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Hip fracture statistics as listed by the International Osteoporosis Foundation:

  • Nearly 75% of all hip fractures occur in women (23).
  • Men account for 25% of hip fractures occurring in the over 50 population (24).
  • Hip fractures are invariably associated with chronic pain, reduced mobility, disability, and an increasing degree of dependence (25).
  • After sustaining a hip fracture 10-20% of formerly community dwelling patients require long term nursing care (26,27,28), with the rate of nursing home admission rising with age (27,29).
  • In white women, the lifetime risk of hip fracture is 1 in 6, compared with a 1 in 9 risk of a diagnosis of breast cancer (9).
  • A 50 year old woman has a 2.8% risk of death related to hip fracture during her remaining lifetime, equivalent to her risk of death from breast cancer and 4 times higher than that from endometrial cancer (30).
  • 5-10% of patients experience a recurrent hip fracture (171,172), with the mean interval between the first and second fracture being 3.3 years (172).
  • Hip fractures cause the most morbidity with reported mortality rates up to 20-24% in the first year after a hip fracture (31,32), and greater risk of dying may persist for at least 5 years afterwards (33).
  • Loss of function and independence among survivors is profound, with 40% unable to walk independently, 60% requiring assistance a year later (34). Because of these losses, 33% are totally dependent or in a nursing home in the year following a hip fracture (32,35,36).
  • Up to 20% of patients die in the first year following hip fractures, mostly due to pre-existing medical conditions. Less than half those who survive the hip fracture regain their previous level of function (25).
  • In women, a fivefold increased risk for all-cause mortality during the first 3 months post-fracture was reported, while men had an eightfold increase over the same time period.
  • Excess mortality persisted after hip fracture at each time interval analyzed (1, 2, 5 and 10 years post-fracture).
  • At ≥ 2 years post-fracture, the relative increase for all-cause mortality was about 2.5-fold and twofold in men and women, respectively, in comparison with the control population–a ratio that was sustained for up to 10 years.”

I love what Mike Vacanti has to say in this video, about the importance of fitness for survival and quality of life:

This is why I strength train. After battling a lifetime eating disorder and overcoming it with strength training, I exercise to optimize my hormones, improve my bone density,and strengthen my body so I can push/pull/squat/hip hinge and plank without incident. When asked what I was training for recently, I responded with, “LIFE, I’m training for life.” Plus, having good glutes will get you everywhere in life and hold your spine together.

And LADIES! I am talking to YOU! Thin, obese, in-between, I don’t care. If you are metabolically unsound (meaning your blood sugars are elevated, your insulin is off and/or you have inflammation) and have low muscle mass, then you are looking at a hip fracture. Especially thin, Caucasian women. Osteoporosis was jokingly called “Skinny white girl disease” in medical school. If you are skinny, protein-starved and hormonally tanked, you are at great risk. If you are obese, then your bones are also obese and your stem cells don’t work to regenerate your body effectively (more on that later).

The solution? Strength Training and building muscle. I’ll share with you the highlights from my Bulletproof talk in coming weeks. The topic? Why “skinny” is dangerous and why obesity is literally killing your stem cells.

In health,

Dr. Tyna

P.S. A heartfelt thank you to all the people who responded personally to my last email. I read every one and was moved to tears. I will miss my Barkley. God spelled backwards is dog, after all.

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References

9. Cummings SR and Melton LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359:1761.

23. Jordan KM and Cooper C (2002) Epidemiology of osteoporosis. Best Pract Res Clin Rheumatol 16:795.

24. Cooper C, Campion G, Melton LJ, 3rd (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2:285.

25. Keene GS, Parker MJ, Pryor GA (1993) Mortality and morbidity after hip fractures. BMJ 307:1248.

26. Autier P, Haentjens P, Bentin J, et al. (2000) Costs induced by hip fractures: a prospective controlled study in Belgium. Belgian Hip Fracture Study Group. Osteoporos Int 11:373.

27. Cree M, Soskolne CL, Belseck E, et al. (2000) Mortality and institutionalization following hip fracture. J AmGeriatr Soc 48:283.

28. Kiebzak GM, Beinart GA, Perser K, et al. (2002) Undertreatment of osteoporosis in men with hip fracture. Arch Intern Med 162:2217.

29. Reginster JY, Gillet P, Ben Sedrine W, et al. (1999) Direct costs of hip fractures in patients over 60 years of age in Belgium. Pharmacoeconomics 15:507.

30. Cummings SR, Black DM, Rubin SM (1989) Lifetime risks of hip, Colles’, or vertebral fracture and coronary heart disease among white postmenopausal women. Arch Intern Med 149:2445.

31. Cooper C, Atkinson EJ, Jacobsen SJ, et al. (1993) Population-based study of survival after osteoporotic fractures. Am J Epidemiol 137:1001.

32. Leibson CL, Tosteson AN, Gabriel SE, et al. (2002) Mortality, disability, and nursing home use for persons with and without hip fracture: a population-based study. J Am Geriatr Soc 50:1644.

33. Magaziner J, Lydick E, Hawkes W, et al. (1997) Excess mortality attributable to hip fracture in white women aged 70 years and older. Am J Public Health 87:1630.

34. Magaziner J, Simonsick EM, Kashner TM, et al. (1990) Predictors of functional recovery one year following hospital discharge for hip fracture: a prospective study. J Gerontol 45:M101.

35. Riggs BL and Melton LJ, 3rd (1995) The worldwide problem of osteoporosis: insights afforded by epidemiology. Bone 17:505S.

36. Kannus P, Parkkari J, Niemi S, Palvanen M (1996) Epidemiology of osteoporotic ankle fractures in elderly persons in Finland. Ann Intern Med 125:975.

37. Kanis JA, Johnell O, De Laet C, et al. (2002) International variations in hip fracture probabilities: implications for risk assessment. J Bone Miner Res 17:1237.

171. Madhok R, Melton LJ, 3rd, Atkinson EJ, et al. (1993) Urban vs rural increase in hip fracture incidence. Age and sex of 901 cases 1980-89 in Olmsted County, U.S.A. Acta Orthop Scand 64:543.

172. Schroder HM, Petersen KK, Erlandsen M (1993) Occurrence and incidence of the second hip fracture. Clin Orthop Relat Res Apr;(289):166.

 

© Dr. Tyna Moore and www.corewellnesspdx.com, 2014-2017. Unauthorized use and/or duplication of this material without express and written permission from this site’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Dr. Tyna Moore and www.corewellnesspdx.com with appropriate and specific direction to the original content.

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