A host of readily identifiable factors, many of which can easily be modified, increase the risk of hip fracture in older women, according to researchers participating in the Study of Osteoporotic Fractures. The study, funded by the National Institutes of Health (NIH), involves more than 9,500 women aged 65 and older and suggests that there are a number of steps women can take that may decrease their fracture risk. These include staying active, walking for exercise, getting treatment for impaired vision, quirting smoking, stopping use of certain medications, reducing caffeine intake, maintaining body weight and taking steps to maintain bone density, including estrogen replacement therapy or other treatments.
The researchers found that women who have five or more risk factors have an especially high likelihood of suffering a hip fracture. Previous results from this group and others show that women with low bone density have a greater risk of hip fracture.
The results are reported in the March 23, 1995 issue of The New England Journal of Medicine by Steven R. Cummings, MD, of the Univeristy of California, San Francisco and his colleagues at UCSF and four participating clinical centers in Baltimore, Minneapolis, Pittsburgh, and Portland.
Cummings and colleagues found that a woman whose mother suffered a hip fracture has twice the risk of hip fracture, and that this risk factor is independent of a woman's bone density.
In addition to women whose mothers had suffered a hip fracture, women who were tall at age 25 and women who weighed less than they had at age 25 also had an increased risk of hip fracture. The more weight a woman had gained since age 25, the lower her risk of hip fracture.
Four observations that were made by physical examination indicated an increased risk of hip fracture: inability to stand from a chair without using one's arms, a resting pulse rate of more than 80 beats per minute, poor depth perception and reduced ability to perceive visual contrast. Being unable to stand up from a chair without using your arms means you are more likely to fall, and doubles your risk of hip fractures.
"The most important thing about this study is that it points out the importance of risk factors besides bone density in the cause of hip fractures," says Cummings. "This is complicated, and bone density clearly plays a role, but so do other factors about the health of the whole woman."