Risk Factors for Hip Fracture in Older Men: The Osteoporotic Fractures in Men Study (MrOS)

Abstract

Almost 30% of hip fractures occur in men; the mortality, morbidity, and loss of independence after hip fractures are greater in men than in women. To comprehensively evaluate risk factors for hip fracture in older men, we performed a prospective study of 5994 men, primarily white, age 65+ years recruited at six US clinical centers. During a mean of 8.6 years of 97% complete follow-up, 178 men experienced incident hip fractures. Information on risk factors including femoral neck bone mineral density (FNBMD) was obtained at the baseline visit. Cox proportional hazards models were used to calculate the hazard ratio (HR) with 95% confidence intervals; Fine and Gray models adjusted for competing mortality risk. Older age (≥75 years), low FNBMD, currently smoking, greater height and height loss since age 25 years, history of fracture, use of tricyclic antidepressants, history of myocardial infarction or angina, hyperthyroidism or Parkinson’s disease, lower protein intake, and lower executive function were all associated with an increased hip fracture risk. Further adjustment for competing mortality attenuated HR for smoking, hyperthyroidism, and Parkinson’s disease. The incidence rate of hip fracture per 1000 person-years (PY) was greatest in men with FNBMD T-scores <−2.5 (white women reference database) who also had 4+ risk factors, 33.4. Men age ≥80 years with 3+ major comorbidities experienced hip fracture at rates of 14.52 versus 0.88 per 1000 PY in men age <70 years with zero comorbidities. Older men with low FNBMD, multiple risk factors, and multimorbidity have a high risk of hip fracture. Many of these assessments can easily be incorporated into routine clinical practice and may lead to improved risk stratification.

Dietary protein and bone health: a systematic review and meta-analysis from the National Osteoporosis Foundation,

“…Nine cohort studies examined hip fracture risk for 3-17 y (Supplemental Table 8) (39,(50)(51)(52)(53)(54)(55)(56)(57). The studies were conducted in different populations: 3 studies (39, 50, 54) were conducted in women [2 (39, 54) of which were conducted in postmenopausal women], 2 (55, 57) were conducted in men, and 4 studies (51-53, 56) were conducted in adults of both sexes.…”

Фактори Ризику Переломів Проксимального Відділу Стегнової Кістки У Хворих Старших Вікових Груп

“…Останнім часом все більшу увагу приділяють вивченню впливу різ-них факторів ризику остеопорозу, що дозволило на-копичити велику доказову базу щодо їх ролі в роз-витку остеопоротичних переломів [3,[11][12][13][14][15]. Так, доведеними факторами ризику переломів ПВСК вважають вік старше від 65 років, належність до жі-ночої статі, попередні переломи в анамнезі, схиль-ність до падінь, сімейний анамнез переломів ПВСК, тривалий прийом глюкокортикоїдів, зловживання алкоголем, дефіцит вітаміну D та наявність деяких соматичних захворювань, зокрема паркінсонізму, цукрового діабету ІІ типу, ревматоїдного артриту та ін.…”

“…Так, доведеними факторами ризику переломів ПВСК вважають вік старше від 65 років, належність до жі-ночої статі, попередні переломи в анамнезі, схиль-ність до падінь, сімейний анамнез переломів ПВСК, тривалий прийом глюкокортикоїдів, зловживання алкоголем, дефіцит вітаміну D та наявність деяких соматичних захворювань, зокрема паркінсонізму, цукрового діабету ІІ типу, ревматоїдного артриту та ін. [3,[13][14][15][16][17][18][19][20].…”

Failure Analysis Following Osteochondroplasty for Hip Impingement in Osteoporotic and Non-Osteoporotic Bones

“…Hip fracture is considered to be one of the most serious potential consequences of osteoporosis [13][14][15][16]. Whilst it is acknowledged that bone quality is an important factor in addition to resection depth and the degree of post-operative weight bearing in femoral neck fractures following hip osteochondroplasty [7,10], the effect of osteoporosis on the risk of postoperative fracture is currently unknown.…”

“…Whilst it is acknowledged that bone quality is an important factor in addition to resection depth and the degree of post-operative weight bearing in femoral neck fractures following hip osteochondroplasty [7,10], the effect of osteoporosis on the risk of postoperative fracture is currently unknown. Since the older population are undertaking recreational and sporting activities with more physical requirements, the symptoms of cam FAI in older patients is likely to become more frequent [16][17][18]. Even though it is relatively uncommon to perform osteochondroplasty for FAI on older patients, it is sometimes appropriate and in addition, osteoporosis is being found increasingly in younger patients [17][18][19][20].…”