Patients with schizophrenia have earlier onset and higher risk of hip fractures

According to them, patients with hip fractures and schizophrenia are younger at index fracture and more likely to present with preexisting frailty and previous fragility fractures.

Schizophrenia patients are at an increased risk of hip fractures. More data should be available regarding the sex-specific burden of hip fractures among schizophrenia patients.

Considering this background, Researchers described the sociodemographic and clinical characteristics of patients with hip fractures and schizophrenia. They quantified their sex-specific annual hip fracture rates relative to those without schizophrenia. In the study, they included patients aged over 40 years.

The study results are:

• Researchers identified 117 431 records of hip fractures.
• There were 109 908 index events.
• 4251/109 908 patients had schizophrenia, and 105 657 did not. (median age 83 years and 31.4% men).
• Patients with hip fractures and schizophrenia were younger at the index event than those without schizophrenia.
• Men and women had a median age of 73 vs 81 years and 80 vs 84 years.
• More patients with vs without schizophrenia had frailty, 53.7% vs 34.2%, with a standardized difference of 0.40 and previous fragility fractures of 23.5% vs 19.1%, with a standardized difference of 0.11.
• The overall age-standardized rate per 10 000 individuals with vs without schizophrenia was 37.5 vs 16.0.
• Age-standardized rates were 3-fold higher in men with vs without schizophrenia and more than 2-fold higher in women with vs without schizophrenia.
• Both study groups had a steady annual decrease of 0.7% in age-standardized rates.

Based on the findings of this study, schizophrenia patients experience an earlier onset and have a higher burden of hip fractures, so it is crucial to implement targeted fracture prevention and optimization of bone health management during treatment.

The study strengths include large population-level data spanning ten years and a diverse general population-based comparison group.

Further research is warranted for elucidating sex-specific causal mechanisms underlying the increased burden and for the evaluation of outcomes and care for patients with schizophrenia who sustain a hip fracture.

Further reading:

Characterization of Hip Fractures Among Adults With Schizophrenia in Ontario, Canada. JAMA Netw Open. 2023;6(4):e2310550. doi:10.1001/jamanetworkopen.2023.10550