Evidence map›Paper›PMID 38918222›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2024

Educational gradient in hip fracture incidence in Norway. The Norwegian Epidemiologic Osteoporosis Studies (NOREPOS).

Kristin Holvik, Cecilie Dahl, Sven Ove Samuelsen, Anne-Johanne Søgaard, Siri Marie Solbakken, Grethe S Tell, Mari Hoff, Berit Schei, Helena Kames Kjeldgaard, Ellen M Apalset and 4 more

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In one paragraph

Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Incidence of proximal humerus fracture among older adults in Oslo, Norway varies by country background, marital status, and season.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Kristin HolvikDepartment of Physical Health and Ageing, Norwegian Institute of Public Health, P. O. Box 222, Skøyen, 0213, Oslo, Norway. kristin.holvik@fhi.no.ORCID http://orcid.org/0000-0003-3132-2822
Cecilie DahlDepartment of Public Health Science, University of Oslo, Oslo, Norway.ORCID http://orcid.org/0000-0001-8143-0907
Sven Ove SamuelsenDepartment of Physical Health and Ageing, Norwegian Institute of Public Health, P. O. Box 222, Skøyen, 0213, Oslo, Norway.
Anne-Johanne SøgaardDepartment of Physical Health and Ageing, Norwegian Institute of Public Health, P. O. Box 222, Skøyen, 0213, Oslo, Norway.ORCID http://orcid.org/0000-0001-8352-4261
Siri Marie SolbakkenDepartment of Physical Health and Ageing, Norwegian Institute of Public Health, P. O. Box 222, Skøyen, 0213, Oslo, Norway.ORCID http://orcid.org/0000-0002-7999-5324
Grethe S TellDepartment of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.ORCID http://orcid.org/0000-0003-1386-1638
Mari HoffDepartment of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.ORCID http://orcid.org/0000-0002-9992-8663
Berit ScheiDepartment of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.ORCID http://orcid.org/0000-0001-7646-4985
Helena Kames KjeldgaardDepartment of Physical Health and Ageing, Norwegian Institute of Public Health, P. O. Box 222, Skøyen, 0213, Oslo, Norway.ORCID http://orcid.org/0000-0003-3824-4927
Ellen M ApalsetDepartment of Rheumatology, Haukeland University Hospital, Bergen, Norway.ORCID http://orcid.org/0000-0003-3821-8008
Bente MorsethSchool of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway.ORCID http://orcid.org/0000-0002-7973-0342
Guri GrimnesDepartment of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.ORCID http://orcid.org/0000-0003-2292-9489
Haakon E MeyerDepartment of Physical Health and Ageing, Norwegian Institute of Public Health, P. O. Box 222, Skøyen, 0213, Oslo, Norway.ORCID http://orcid.org/0000-0002-3262-8260
Tone Kristin OmslandDepartment of Community Medicine and Global Health, University of Oslo, Oslo, Norway.ORCID http://orcid.org/0000-0002-0808-3133

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Examining fracture dynamics by socioeconomic status may inform healthcare and prevention. We found a higher risk of hip fracture in men and women with lower educational level in Norway. However, by age 90 + years, the cumulative incidence was higher in those with higher education, due to their higher life expectancy. PURPOSE: Socioeconomic gradients are seen for several health outcomes in high-income countries. We aimed to examine possible educational gradients in risk of hip fracture in Norway and to describe the cumulative incidence of hip fracture by educational level.

methodsIn a population-wide cohort of Norwegians aged ≥ 50 years, information on attained education from Statistics Norway was linked to hospital-treated hip fractures and deaths during 2002-2019. We estimated relative fracture risk by educational level (primary, secondary or tertiary) in Cox proportional hazards regression. We also examined the cumulative incidence over attained age by gender and educational level in competing risk regression.

resultsThe population included N = 1,389,858 individuals with 135,938 incident hip fractures. Compared with men who had attained tertiary education, hazard ratios (95% confidence intervals) for hip fracture were 1.44 (1.40, 1.49) in men with primary education only and 1.26 (1.22, 1.29) in men with secondary education. In women, the corresponding estimates were 1.28 (1.25, 1.31) and 1.16 (1.13, 1.19). In the age range 50 to 90 years, the highest cumulative incidence of hip fracture was seen in those with primary education. The gradient gradually diminished with advancing age and was reversed in the oldest (> 90 years) in both genders.

conclusionsThere was a clear educational gradient in hip fracture incidence in both men and women in Norway, with a higher risk in people with lower education. Despite this, the cumulative incidence of hip fracture in old age was highest among people with higher education, due to their higher life expectancy.

Indexed as

Educational StatusHip FracturesOsteoporotic FracturesAgedAged, 80 and overAge DistributionFemaleHumansIncidenceMaleMiddle AgedNorwayRisk FactorsSex DistributionEducationHip fractureNorwayRegistry-based epidemiologySocio-economic status

Identifiers

PMID38918222
PMCPMC11499405

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.