Mortality after all major types of osteoporotic fracture in men and women: an observational study

Nguyen, Tuan V.; Schneider, Diane L.; Sambrook, Philip N.; Eisman, John A.

doi:10.1016/s0140-6736(98)09075-8

Cited by 1,707 publications

(1,076 citation statements)

References 22 publications

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“…Other studies reported that increased mortality after hip and vertebral fractures was consistent over the initial five-year period. (4,6,8,11) In the present study, prevalent morphometric vertebral deformity and prevalence of hip fracture were not associated with increased mortality. Inconsistency between our report and many previous studies can be explained by differences between incidence and prevalence of fracture, because prevalent vertebral deformity and hip fracture in our study included those cases that had developed many years in the past.…”

Section: Journal Of Bone and Mineral Researchsupporting

confidence: 39%

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Height loss starting in middle age predicts increased mortality in the elderly

Masunari

Fujiwara

Kasagi

et al. 2011

Journal of Bone and Mineral Research

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The purpose of this study was to determine the mortality risk among Japanese men and women with height loss starting in middle age, taking into account lifestyle and physical factors. A total of 2498 subjects (755 men and 1743 women) aged 47 to 91 years old underwent physical examinations during the period 1994 to 1995. Those individuals were followed for mortality status through 2003. Mortality risk was estimated using an age-stratified Cox proportional hazards model. In addition to sex, adjustment factors such as radiation dose, lifestyle, and physical factors measured at the baseline-including smoking status, alcohol intake, total cholesterol, blood pressure, and diagnosed diseases-were used for analysis of total mortality and mortality from each cause of death. There were a total of 302 all-cause deaths, 46 coronary heart disease and stroke deaths, 58 respiratory deaths including 45 pneumonia deaths, and 132 cancer deaths during the follow-up period. Participants were followed for 20,787 person-years after baseline. Prior history of vertebral deformity and hip fracture were not associated with mortality risk. However, more than 2 cm of height loss starting in middle age showed a significant association with all-cause mortality among the study participants (HR ¼ 1.76, 95% CI 1.31 to 2.38, p ¼ 0.0002), after adjustment was made for sex, attained age, atomic-bomb radiation exposure, and lifestyle and physical factors. Such height loss also was significantly associated with death due to coronary heart disease or stroke (HR ¼ 3.35, 95% CI 1.63 to 6.86, p ¼ 0.0010), as well as respiratory-disease death (HR ¼ 2.52, 95% CI 1.25 to 5.22, p ¼ 0.0130), but not cancer death. Continuous HL also was associated with all-cause mortality and CHD-or stroke-caused mortality. Association between height loss and mortality was still significant, even after excluding persons with vertebral deformity. Height loss of more than 2 cm starting in middle age was an independent risk factor for cardiovascular and respiratory-disease mortality among the elderly, even after adjusting for potential risk factors. ß

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Section: Journal Of Bone and Mineral Researchsupporting

confidence: 39%

“…M any studies have shown increased fracture risk (1)(2)(3) and mortality (4)(5)(6)(7)(8) after clinical vertebral fracture. Even subjects with no clinical fracture and little pain but with vertebral deformity detected by X-ray showed slightly increased mortality.…”

Section: Introductionmentioning

confidence: 98%

Height loss starting in middle age predicts increased mortality in the elderly

Masunari

Fujiwara

Kasagi

et al. 2011

Journal of Bone and Mineral Research

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“…Bone mineral density (BMD) is similar to serum cholesterol as a predictor of heart disease and blood pressure as a predictor of stroke. 2 Bone turnover is a dynamic process and is important when considering the management of osteoporosis. 3 Bone turnover involves degradation of the bone matrix by osteoclasts and the formation of new matrix by osteoblasts.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Central and Peripheral Bone Mineral Density Measurements in Postmenopausal Women

Abdelmohsen

2017

Journal of Chiropractic Medicine

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Objectives: The purpose of the current study was to compare central and peripheral bone mineral density at different regions including spine, hip, and wrist in postmenopausal women. Methods: Forty postmenopausal women participated in this study. Their mean age, body mass, height, and body mass index were 53.5 ± 2.75 y, 68.6 ± 8.68 kg, 167.8 ± 6.46 cm, and 24.31 ± 1.69 kg/m 2 , respectively. Bone mineral density (BMD) T-scores of spine, hip, and wrist regions were measured for all participants with a dual-energy X-ray absorptiometry scan. Results: All measured regions (spine, hip, and wrist) had low BMD T-scores. Bone mineral density of the wrist was significantly lower (-2.58 ± 2.18) than that of both spine (-1.79 ± 0.98) and hip (-1.69 ± 1.37). In addition, there were no statistically significant differences in BMD between the spine and hip. Conclusions: In this group of postmenopausal women, wrist BMD decreased more than spine and hip BMD. Both spine and hip BMD decreased by nearly the same percentage in postmenopausal women. Peripheral sites may be more representative of osteoporosis than central sites.

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“…(5,7) In addition to health care costs, osteoporotic fractures significantly impact mortality and patient quality of life by inducing pain, physical limitations, and psychological symptoms, including depression and loss of self-esteem, resulting in institutionalization and long-term care. (2,4,(8)(9)(10)(11)(12)(13)(14) Pharmacotherapies currently available for the prevention and treatment of osteoporosis include oral bisphosphonates (OBP), calcitonin, estrogen/hormone therapy, the estrogen agonist/ antagonist raloxifene, and the recombinant parathyroid hormone teriparatide. Among these, bisphosphonates are the most commonly used treatment for established osteoporosis with a market share of 35% in the US.…”

Section: Introductionmentioning

confidence: 99%

Long-term impact of adherence to oral bisphosphonates on osteoporotic fracture incidence

Sampalis

Adachi

Rampakakis

et al. 2011

Journal of Bone and Mineral Research

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Adherence to osteoporosis treatments is a critical parameter resulting in suboptimal effectiveness in real-life practice. The long-term effect of adherence on fracture risk has not been assessed. This was a retrospective study using provincial health insurance claims databases to assess the association between adherence to oral bisphosphonates (OBP) and incidence of osteoporotic fractures in all Ontario patients with osteoporosis between April 1996 and December 2009. Multivariate logistic regression models were used to assess the association between OBP adherence and fracture risk. Treatment duration was classified into 2-year intervals. Compliance was estimated with the medication possession ratio (MPR), and persistence was defined as the length of continuous therapy without a gap in refills >30 days. The study cohort was composed of 636,114 patients, among whom 36.1% were prescribed OBPs for 0 to 2 years, 19.7% for 2 to 4 years, 15.1% for 4 to 6 years, 12% for 6 to 8 years, 9.1% for 8 to 10 years, 6.1% for 10to 12 years, and 1.9% for 12 to 14 years. Overall, the mean (SD) compliance for the cohort was 0.72 (0.30) with 53.5% of the patients having compliance >80% and 24.6% being persistent with treatment during the 14-year follow-up period. Significant associations between high adherence and reduced fracture risk over the entire 14-year period were observed; the overall odds ratio for categorical compliance (MPR >80% or MPR 80%), continuous compliance, and persistence were 0.909 (95% confidence interval [CI] 0.893-0.925), 0.918 (95% CI 0.893-0.944), and 0.804 (95% CI 0.787-0.821), respectively. In conclusion, adherence to OBP in osteoporosis management is suboptimal in a real-life setting. A significant positive association exists between poor adherence and increased risk of osteoporotic fractures, which becomes augmented with longer treatment duration. ß

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Mortality after all major types of osteoporotic fracture in men and women: an observational study

Cited by 1,707 publications

References 22 publications

Height loss starting in middle age predicts increased mortality in the elderly

Height loss starting in middle age predicts increased mortality in the elderly

Comparison of Central and Peripheral Bone Mineral Density Measurements in Postmenopausal Women

Long-term impact of adherence to oral bisphosphonates on osteoporotic fracture incidence

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