This Article Full Text Full Text (PDF) All Versions of this Article: 92/3/955    most recent Author Manuscript (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Nguyen, N. D. Articles by Nguyen, T. V. Search for Related Content PubMed PubMed Citation Articles by Nguyen, N. D. Articles by Nguyen, T. V. Related Collections Calcium and Bone Metabolism

Risk Factors for Fracture in Nonosteoporotic Men and Women

Bone and Mineral Research Program (N.D.N., J.A.E., J.R.C., T.V.N.), Garvan Institute of Medical Research, and the Department of Endocrinology (J.A.E., J.R.C.), St. Vincent’s Hospital, and the Faculty of Medicine (J.A.E., T.V.N.), The University of New South Wales, Sydney, New South Wales 2010, Australia

Address all correspondence and requests for reprints to: Tuan V. Nguyen, Bone and Mineral Research Program, Garvan Institute of Medical Research, St. Vincent’s Hospital, 384 Victoria Street, Darlinghurst, Sydney, New South Wales 2010, Australia. E-mail: t.nguyen{at}garvan.org.au.

Context and Objective: It is not known which factors are associated with fracture in nonosteoporotic elderly. The aim of this study was to assess the association between fall-related risk factors and fracture risk in men and women without osteoporosis.

Design: This study was part of the ongoing Dubbo Osteoporosis Epidemiology Study, which was designed as a prospective population-based cohort investigation.

Participants: At baseline, 924 women and 723 men aged 60+ yr did not have osteoporosis [bone mineral density (BMD) T-scores > –2.5]. The individuals have been followed for up to 15 yr.

Main Outcome Measures: Atraumatic fractures were prospectively identified through radiologists’ reports.

Risk Factors: At baseline, femoral neck BMD (FNBMD) was measured by dual energy x-ray absorptiometry (DXA); history of fall, postural stability, and quadriceps strength was obtained.

Results: During the follow-up period, among the nonosteoporotic group, 221 women and 105 men had sustained a fracture, accounting for 55 and 74% of total fractures in the entire Dubbo Osteoporosis Epidemiology Study sample, respectively. The following factors were independent risk factors for any fracture: in women, age per SD (hazard ratio, 1.2; 95% CI, 1.0–1.3), postural sway per SD (1.1, 1.0–1.2), FNBMD per SD (1.6, 1.3–1.9), fall in the previous 12 months (2.1, 1.6–2.7), and prior fracture (1.8, 1.2–2.7); in men, age (1.4, 1.1–1.6), postural sway (1.2, 1.0–1.3), FNBMD (1.2, 1.0–1.5), and fall in the previous 12 months (1.9, 1.2–3.0). Exposure to at least one of the risk factors could account for 49% (women) and 39% (men) of any fractures in this population.

Conclusion: In nonosteoporotic elderly, the combination of low BMD, advancing age, fall during the last 12 months, and prior fracture could identify a subgroup of individuals with high risk of fracture.

This article has been cited by other articles:

				S. Parikh, H. Mogun, J. Avorn, and D. H. Solomon Osteoporosis Medication Use in Nursing Home Patients With Fractures in 1 US State Arch Intern Med, May 26, 2008; 168(10): 1111 - 1115. [Abstract] [Full Text] [PDF]