In the Journals

Multiple risk factors, BMD associated with hip fracture in older men

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April 18, 2016

Older men with an increasing number of specific risk factures combined with decreased bone mineral density at the femoral neck are at elevated risk for hip fracture, according to study findings.

Jane A. Cauley, DrPH , professor and vice chair for research in the department of epidemiology at the University of Pittsburgh Graduate School of Public Health, and colleagues analyzed data from 5,876 men not assigned osteoporosis medications at baseline who participated in the Osteoporotic Fractures in Men (MrOS) study, a multicenter, prospective study of risk factors for fractures. Researchers followed the cohort for incident hip fractures (regardless of trauma level) for a mean of 8.6 years; questionnaires were administered by telephone or mail every 3 years, and hip fractures were verified by physician adjudication of medical records.

During the follow-up period, 178 men (3%) experienced an incident hip fracture; age-adjusted incidence was 3.5/1,000 person-years. Men who sustained a hip fracture were more likely to be older than 75 years, have lower body weight and femoral neck BMD, and experience greater height loss since age 25 years. Men who sustained a hip fracture also were more likely to smoke and experience a previous fracture or fall after age 50 years. Self-reported history of myocardial infarction or angina, Parkinson’s disease, hyperthyroidism and poorer executive function were all related to an increased risk for hip fracture after multivariable adjustment.

Researchers found that older men with a BMD T-score of –2.5 or less (n = 128) had a risk for hip fracture that increased along with an increasing number of risk factors.

“For example, the incidence of hip fracture (per 1,000 [person-years]) was 33.4 (95% CI, –32.1 [to] 98.8) among osteoporotic men with four or more risk factors compared with 4.09 (95% CI, –4.7 [to] 14.5) among men with T-scores –1 and four or more risk factors,” the researchers wrote. “Similarly, among the 1,923 (35.3%) men with T-scores of –1 to –2.5, the incidence of hip fracture (per 1,000 [person-years]) increased from 1.41 (95% CI, 0.4-2.5) among men with [no] risk factors to 27.7 (95% CI, 0.6-54.8) among men with four or more.”

Researchers found that, within each age group, the incidence of hip fracture increased with increasing number of comorbidities. Men older than 80 years with three or more comorbidities experienced the highest incidence of hip fracture. – by Regina Schaffer

Disclosure: The researchers report no relevant financial disclosures.

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