Available clinical evidence suggests that individuals with schizophrenia are at augmented risk of hip fractures; however, the gender-specific burden of hip fractures among adults with schizophrenia has not been measured and compared with the general population.

In a recent publication in the Journal of the American Medical Association Network Open, researchers aimed to explain the sociodemographic and clinical characteristics of patients with hip fractures and schizophrenia and to calculate their gender-specific annual hip fracture rates relative to individuals without schizophrenia.

The primary outcomes were gender-specific, age-standardized annual hip fracture rate per 10,000 individuals and annual percent change in age-standardized rates. The rates were direct adjusted to the 2011 Ontario population, and joinpoint regression analysis was conducted to assess annual percent change.

The population-based, cross-sectional study was conducted between April 2009 and March 2019 and included data from 109,908 adults aged between 40 to 105 years who had hip fracture–related hospitalizations. Statistical analysis was completed between November 2021 and February 2023.

The researchers indicated that among the 109,908 patients with hip fractures, 4,251 had schizophrenia and 105,657 did not have schizophrenia. The average age among participants was 83 years (interquartile range 75-89 years), and 31.4% of the study population were men.

The results revealed that the annual age-standardized rate was 38 versus 16 hip fractures per 10,000 individuals with schizophrenia versus those without schizophrenia, with greater relative differences detected among men. Moreover, findings revealed that patients with schizophrenia and hip fracture were younger, were more likely to be frail, and were more likely to have a history of previous fragility fractures.

In conclusion, the authors wrote, “The findings of this cross-sectional study suggest that individuals with schizophrenia may experience earlier onset and a substantially higher annual age-standardized rate of hip fractures compared with the general population, with greater relative differences among men. Patients with hip fractures and schizophrenia are also more likely to have previous fragility fractures and meet criteria for frailty.”

They also added that their findings have meaningful implications for targeted fracture prevention and enhancing clinical management of bone health in those with schizophrenia.

Lastly, they wrote, “Further research is needed to elucidate gender-specific causal mechanisms underlying the increased burden and to evaluate outcomes and care for patients with schizophrenia who sustain a hip fracture.”

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