老年人群神经退行性疾病增加桡骨远端骨折风险：一项全国性研究

Q3 Medicine

Journal of Hand Surgery Global Online Pub Date : 2025-06-19 DOI:10.1016/j.jhsg.2025.100740

Gregory R. Vance BE , Katherine Benedict MD , Evan C. Bowen BS , Bradley F. Hathaway BA , Clay B. Thames BA , Marc E. Walker MD, MBA

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引用次数: 0

摘要

目的提高老年神经退行性疾病的患病率，迫切需要在这些人群中确定常见损伤的特征，以便有针对性地预防损伤。尽管由于年龄相关的衰退，桡骨远端骨折（DRF）在老年人中很常见，但目前的研究旨在报告神经退行性疾病与该老年队列中DRF发病率之间的关系。本研究中使用的数据来自Epic Cosmos，这是一个卫生系统的社区合作，代表了来自1301多家医院和28600多家诊所的2.27亿多例患者记录。所有年龄在2013年12月7日至2023年12月6日之间的60岁以上的患者被纳入，并根据神经退行性疾病诊断使用注册信息和国际疾病分类10代码进行分类。60岁后桡骨远端骨折发生率采用国际疾病分类10码测量，并记录99%置信区间。计算有和没有神经退行性疾病的DRF的优势比。结果在阿尔茨海默病和痴呆症登记处登记的患者与未登记的患者相比，60岁后DRF发病率增加。根据诊断分层，阿尔茨海默病的DRF发病率高于帕金森病、亨廷顿病、额颞叶痴呆、路易体和常压脑积水。所列的每一种疾病与DRF的发生率均高于没有这种疾病的患者。结论无并发症的衰老无疑与运动功能减退有关，但常见的神经退行性疾病，尤其是阿尔茨海默病，可能会加剧这种关系。虽然认知症状可能更明显，但受这些疾病影响的患者可能需要格外仔细的监测，因为跌倒和骨折的风险增加。证据水平鉴别诊断/症状患病率研究IV。

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Neurodegenerative Conditions in the Geriatric Population Increase Risk of Distal Radius Fracture: A Nationwide Study

Purpose

Rising prevalence of geriatric neurodegenerative conditions calls for urgency to characterize common injuries in these populations for adequate targeted injury prevention. Although distal radius fracture (DRF) is common in older populations because of age-related decline, the current study aimed to report on associations between neurodegenerative conditions and DRF incidence in this senior cohort.

Methods

Data used in this study came from Epic Cosmos, a community collaboration of health systems representing more than 227,000,000 patient records from more than 1,301 hospitals and 28,600 clinics. All patients aged at least 60 years with an encounter between December 7, 2013, and December 6, 2023, were included and sorted based on neurodegenerative condition diagnoses using registry information and International Classification of Diseases 10 codes. Distal radius fracture incidence after the age of 60 years was measured using International Classification of Diseases 10 codes, and 99% confidence intervals were recorded. Odds ratios of DRF between those with and without neurodegenerative conditions were calculated.

Results

Patients listed in the Alzheimer and Dementia Registry compared with those not listed had an increase in DRF incidence after the age of 60 years. Stratified by diagnosis, Alzheimer disease was associated with higher DRF incidence than Parkinson disease, Huntington disease, frontotemporal dementia, Lewy body, and normal pressure hydrocephalus. Each condition listed was associated with a higher incidence of DRF than those without the condition.

Conclusions

Although uncomplicated aging is undoubtedly associated with diminished motor function, this relationship may be exacerbated by common neurodegenerative conditions, especially Alzheimer disease. Although cognitive symptoms may be more evident, patients affected by these conditions may need exceptionally diligent monitoring because of increased fall and fracture risk.