Dementia and the Risk of Hip Fracture

Dear Editor,

The recent study of Jeon et al.¹ in the Journal of Clinical Neurology found that dementia was associated with an increased risk of hip fracture (hazard ratio=2.840, 95% confidence interval=2.449–3.293). The incidence-rate ratio of hip fracture in people with dementia versus people without dementia observed by Jeon et al.¹ was compatible with those found in previous studies (range=1.89–2.99).²,³ I would like to share the following ideas with the readers: first, Jeon et al.¹ demonstrated that the incidence of hip fracture was 2.99-fold higher in people with dementia than those without dementia (1573.04 vs. 526.69 per 100,000 person-years).¹ Those authors found that the attributable risk of hip fracture associated with dementia was 1046.35 per 100,000 person-years, and the number needed to harm was 95.57. Second, one recent cohort study in Sweden found that the attributable risk of hip fracture associated with inflammatory bowel disease was 45 per 100,000 person-years and that the number needed to harm was 2,222.⁴ Based on the above measurements, the probability of hip fracture seems to be higher in people with dementia than those with inflammatory bowel disease. Third, most cases of hip fracture result from falls. From a point of primary prevention, programs to prevent falls and subsequent hip fractures should be initiated in people with dementia. Finally, I appreciate the great efforts made by Jeon et al.¹ to provide updated information on the association between dementia and hip fracture.