Low bone mineral density is associated with increased mortality in elderly men: MrOS Sweden

Johansson, Helena; Odén, Anders; Kanis, John А.; McCloskey, Eugène; Lorentzon, Mattias; Ljunggren, Östen; Karlsson, Magnus K.; Orwoll, Eric; Tivesten, Åsa; Ohlsson, Claes; Mellström, Dan

doi:10.1007/s00198-010-1331-1

Cited by 33 publications

(20 citation statements)

References 22 publications

(52 reference statements)

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“…Several studies have found that baseline BMD is inversely related to subsequent mortality in elderly women and men. (7)(8)(9)11,12,34) Further, in a large cohort of white women 65 years of age and older, a greater decline in BMD was associated with increased mortality from all causes and CVD, regardless of initial BMD. (35) The mechanism of this association is unknown.…”

Section: Discussionmentioning

confidence: 90%

Bone Mineral Density and Parathyroid Hormone as Independent Risk Factors for Mortality in Community-Dwelling Older Adults: A Population-Based Prospective Cohort Study in Brazil. The São Paulo Ageing & Health (SPAH) Study

Domiciano

Machado

Lopes

et al. 2016

Journal of Bone and Mineral Research

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Previous studies have shown a relationship between osteoporosis and increased mortality risk. However, none of these studies performed a concomitant evaluation of the parathyroid hormone (PTH)-calcium-vitamin D axis and bone mass to accurately determine the contribution of each of these parameters to survival in older subjects. Thus, we sought to investigate the association between bone parameters and mortality in a longitudinal, prospective, population-based cohort of 839 elderly subjects. Clinical data (including history of fractures and cardiovascular events) were assessed using a specific questionnaire. Laboratory exams, including serum 25OHD and PTH, were also performed. Bone mineral density (BMD) at the lumbar spine and hip were evaluated using DXA. All analyses were performed at baseline (2005 to 2007). Mortality was recorded during follow-up. Multivariate Cox proportional regression was used to compute hazard ratios for all-cause and cardiovascular mortality. Over a mean 4.06 AE 1.07 years, there were 132 (15.7%) deaths. These individuals were compared to 707 subjects who were alive at the end of the coverage period for mortality data collection. In a multivariate Cox proportional hazards model, age (HR 1.32; 95% CI, 1.13 to 1.55; p ¼ 0.001, for each 5-year increase), male gender (HR 1.90; 95% CI, 1.30 to 2.79; p ¼ 0.001), recurrent falls (more than two in the previous year; HR 1.65; 95% CI, 1.06 to 2.56; p ¼ 0.026), diabetes mellitus (HR 2.17; 95% CI, 1.46 to 3.21; p < 0.001), low physical activity score (HR 1.78; 95% CI, 1.14 to 2.79; p ¼ 0.011), prior cardiovascular event (HR 1.76; 95% CI, 1.18 to 2.63; p ¼ 0.006), total hip BMD (HR 1.41; 95% CI, 1.15 to 1.72; p ¼ 0.001, per each 1 SD decrease), and intact PTH (iPTH) (HR 1.06; 95% CI, 1.04 to 1.08; p < 0.001, per each 10 pg/mL increase) were independently associated with all-cause mortality. The subjects in the highest quartile of PTH (>49 pg/mL) were at a higher risk of cardiovascular death (HR 3.09; 95% CI, 1.36 to 6.99; p ¼ 0.007) compared with the subjects in the lowest quartile (<26 pg/mL). Low BMD and higher PTH were significantly associated with mortality in community-dwelling older adults. These findings support the notion that careful screening of these bone parameters might lead to better management of older patients and improve outcomes in this population.

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Section: Discussionmentioning

confidence: 90%

Bone Mineral Density and Parathyroid Hormone as Independent Risk Factors for Mortality in Community-Dwelling Older Adults: A Population-Based Prospective Cohort Study in Brazil. The São Paulo Ageing & Health (SPAH) Study

Domiciano

Machado

Lopes

et al. 2016

Journal of Bone and Mineral Research

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“…The present study was from the Swedish stratum of MrOS (n=3014) recruited at medical centres in Gothenburg (n=1010), Malmö (n=1005) and Uppsala (n=999). Details have been described previously [34][35][36]. In brief, men aged 70-81 years were randomly identified using national population registers.…”

Section: Methodsmentioning

confidence: 99%

“…DXA measurements performed with equipment from different manufacturers were converted to a standardized BMD, as previously described [34][35][36][37].…”

Section: Methodsmentioning

confidence: 99%

Low serum vitamin D is associated with increased mortality in elderly men: MrOS Sweden

et al. 2011

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“…25 Low BMD has shown to be a strong predictor of fracture risk and mortality in older men. 26 AST rapidly decreases testosterone levels to a hypogonadal state and, as a result, a number of studies involving men receiving AST have demonstrated an accelerated bone loss. 6,9,14,15,27--31 A summary of the studies that reported rates of bone loss as a percentage is shown in Table 2.…”

Section: Osteoporosis and Fractures During And Following Astmentioning

confidence: 99%

AST-induced bone loss in men with prostate cancer: exercise as a potential countermeasure

Bolam

Galvão

Spry

et al. 2012

Prostate Cancer Prostatic Dis

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Androgen suppression treatment (AST) for men with prostate cancer is associated with a number of treatment-related side effects including an accelerated rate of bone loss. This loss of bone is greatest within the first year of AST and increases the risk for fracture. Pharmaceutical treatment in the form of bisphosphonates is currently used to counter the effects of hormone suppression on bone but is costly and associated with potential adverse effects. Recently, exercise has been shown to be an important adjuvant therapy to manage a range of treatment-related toxicities and enhance aspects of quality of life for men receiving AST. We propose that physical exercise may also have an important role in not only attenuating the bone loss associated with AST but in improving bone health and reducing fracture risk. In this review, the rationale underlying exercise as a countermeasure to AST-induced bone loss is provided.

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Low bone mineral density is associated with increased mortality in elderly men: MrOS Sweden

Cited by 33 publications

References 22 publications

Bone Mineral Density and Parathyroid Hormone as Independent Risk Factors for Mortality in Community-Dwelling Older Adults: A Population-Based Prospective Cohort Study in Brazil. The São Paulo Ageing & Health (SPAH) Study

Bone Mineral Density and Parathyroid Hormone as Independent Risk Factors for Mortality in Community-Dwelling Older Adults: A Population-Based Prospective Cohort Study in Brazil. The São Paulo Ageing & Health (SPAH) Study

Low serum vitamin D is associated with increased mortality in elderly men: MrOS Sweden

AST-induced bone loss in men with prostate cancer: exercise as a potential countermeasure

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