The role of the fracture liaison service in the prevention of atypical femoral fractures
Giuseppe Toro,
Adriano Braile,
Sara Liguori
et al.
Abstract:Osteoporosis and fragility fractures (FFs) are considered critical health problems by the World Health Organization (WHO) because of high morbidity, mortality, and healthcare costs. The occurrence of a FF raises the risk of a subsequent fracture (refracture). The hip is the most common site of fragility refracture, and its onset is associated with a further increase in patient’s morbidity, mortality, and socioeconomic burden. Therefore, the prevention of refracture is essential. In this context, fracture liais… Show more
Objectives
Therapeutic advances in management of osteoporosis and sarcopenia have occurred at different rates over the last two decades; here we examined associations between grip strength and bone mineral density (BMD) with subsequent all-cause and cause-specific mortality in a UK community-dwelling cohort.
Methods
Data from 495 men and 414 women from the Hertfordshire Cohort Study were analysed. Grip strength was assessed by grip dynamometry; femoral neck BMD was ascertained using DXA; deaths were recorded from baseline (1998–2004) until 31st December 2018. Grip strength and BMD in relation to mortality outcomes (all-cause, cardiovascular-related, cancer-related, and mortality due to other causes) were examined using Cox regression with adjustment for age and sex.
Results
Mean (SD) baseline age of participants was 64.3 (2.5) and 65.9 (2.6) years in men and women respectively. Lower grip strength was associated with increased risk of all-cause mortality (hazard ratio (95% CI): 1.30 (1.06,1.58), p = 0.010) and cardiovascular-related mortality (1.75 (1.20,2.55), p = 0.004). In contrast, BMD was not associated with any of the mortality outcomes (p > 0.1) for all associations.
Conclusion
We report strong relationships between grip strength and mortality in comparison with BMD. We hypothesize that this may reflect better recognition and treatment of low BMD in this cohort.
Objectives
Therapeutic advances in management of osteoporosis and sarcopenia have occurred at different rates over the last two decades; here we examined associations between grip strength and bone mineral density (BMD) with subsequent all-cause and cause-specific mortality in a UK community-dwelling cohort.
Methods
Data from 495 men and 414 women from the Hertfordshire Cohort Study were analysed. Grip strength was assessed by grip dynamometry; femoral neck BMD was ascertained using DXA; deaths were recorded from baseline (1998–2004) until 31st December 2018. Grip strength and BMD in relation to mortality outcomes (all-cause, cardiovascular-related, cancer-related, and mortality due to other causes) were examined using Cox regression with adjustment for age and sex.
Results
Mean (SD) baseline age of participants was 64.3 (2.5) and 65.9 (2.6) years in men and women respectively. Lower grip strength was associated with increased risk of all-cause mortality (hazard ratio (95% CI): 1.30 (1.06,1.58), p = 0.010) and cardiovascular-related mortality (1.75 (1.20,2.55), p = 0.004). In contrast, BMD was not associated with any of the mortality outcomes (p > 0.1) for all associations.
Conclusion
We report strong relationships between grip strength and mortality in comparison with BMD. We hypothesize that this may reflect better recognition and treatment of low BMD in this cohort.
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