Risk factors for osteoporotic fractures in elderly men

Nguyen, T.V.; Eisman, John A.; Kelly, Paul; Sambrook, P N

doi:10.1016/s0378-5122(97)88489-7

Cited by 90 publications

(141 citation statements)

References 27 publications

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“…Moreover, another study also showed that walking can reduce fracture risk among postmenopausal women [24]. In contrast with our results, other investigators found that balance (tandem stand or postural sway) appeared to be an independent risk factor for fractures [8,9]. These differences might exist because the balance tests in other studies were mainly performed in clinical centers, whereas the LASA study is performed at home.…”

Section: Discussioncontrasting

confidence: 99%

“…Studying treatable risk factors in a prospective cohort study might help to determine which risk factors should be included in an intervention strategy. Only a few prospective cohort studies have examined the association between treatable risk factors, such as physical functioning, and the risk of hip fractures [5,6,7] or other osteoporotic fractures [8,9,10].…”

Section: Introductionmentioning

confidence: 99%

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Functional limitations and poor physical performance as independent risk factors for self-reported fractures in older persons

Stel¹,

Pluijm²,

Deeg³

et al. 2004

Osteoporos Int

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Objective: This study examined whether three aspects of functioning (i.e., functional limitations, physical performance, and physical activity) were associated with fractures in older men and women. Design: A 3-year prospective cohort study. Participants and setting: A total of 715 men and 762 women, aged 65 years and older, of the population-based Longitudinal Aging Study Amsterdam. Measurements: During an interview at home, three aspects of functioning were assessed: functional limitations (what people say they can do), physical performance, i.e., three performance tests and handgrip strength (what people are able to do), and physical activity (what people actually do). Afterward, a follow-up on fractures was conducted for 3 years. Results: 77 patients (5.2%) suffered a fracture during 3-year follow-up. Most patients suffered a hip fracture (1.6%) or a wrist fracture (1.4%). The fracture rate per 1,000 person-years was 20.1. During 3-year follow-up, a fracture was reported by 12%, 10%, 12%, and 6% of the respondents with functional limitations, low performance test score, poor handgrip strength, and low physical activity, respectively. Using Cox proportional hazard analysis, functional limitations (RR=3.5; 95%CI, 2.1 to 6.0), low performance test score (RR=1.9; 95% CI, 1.1 to 3.3), low handgrip strength (RR=2.5; 95% CI, 1.5 to 4.1), and low physical activity (RR=1.9; 95% CI, 1.1 to 3.5) were significantly associated with fractures after adjustment for age and sex.Functional limitations (RR=3.2; 95% CI, 1.8 to 5.5), low performance test score (RR=1.8; 95% CI, 1.0 to 3.3) and low handgrip strength (RR=2.0; 95% CI, 1.1 to 3.6) remained significantly associated with fractures after additional adjustment for body composition, chronic diseases, psychosocial factors, life style factors, and the other levels of functioning. No significant interaction terms were found. Conclusions: Functional limitations and poor physical performance were independent risk factors for fractures.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Functional limitations and poor physical performance as independent risk factors for self-reported fractures in older persons

Stel¹,

Pluijm²,

Deeg³

et al. 2004

Osteoporos Int

View full text Add to dashboard Cite

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“…16 Several other factors are known to increase the risk for hip fracture, such as advanced age, 17 region of the world, 18 quadriceps weakness, 19 low body mass index, postural instability, 20 previous fracture, 21 female sex, and history of parent's hip fracture. [22][23][24][25] Our study, similar to several previous studies, highlights the value of some of these risk factors in hip fracture risk stratification. An Australian study found that frailty-related risk factors such as advanced age, reduced weight, quadriceps weakness, and postural instability were each associated with increased risk of hip fracture.…”

Section: Discussionsupporting

confidence: 89%

The Elders Risk Assessment Index, an Electronic Administrative Database–Derived Frailty Index, Can Identify Risk of Hip Fracture in a Cohort of Community-Dwelling Adults

Albaba

Stephen

Takahashi

2012

Mayo Clinic Proceedings

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Objective: To determine whether an Elders Risk Assessment (ERA) index can predict incident hip fractures without the need for physician-patient encounter or bone mineral density testing. Patients and Methods: A retrospective cohort study was conducted in a community-based cohort of 12,650 patients aged 60 years and older. An ERA score was computed for each subject at index time (January 1, 2005). Incidents of hip fracture from January 1, 2005, through December 31, 2006, were obtained from electronic medical records. We divided the cohort into 5 groups, with the lowest ERA scores forming group A (Ͻ15%); 15% to 49%, group B; 50% to 74%, group C; 75% to 89%, group D; and the top 11%, group E. With group A as a reference group, we used logistic regression to compute odds ratios of sustaining hip fracture during a 2-year period (January 1, 2005, through December 31, 2006) for groups B, C, D, and E. Sensitivity and specificity of each possible ERA score were calculated, and a receiver operating characteristic curve was created. Results: Two hundred sixty-five patients (2.1%) sustained at least 1 hip fracture from January 1, 2005, through December 31, 2006. Odds ratios (95% confidence intervals) for groups B, C, D, and E were 1.6 (0.7-3.4), 4.5 (2.2-9.4), 6.9 (3.3-14.3), and 18.4 (8.9-37.9), respectively. The area under the receiver operating characteristic curve was 74.5%. Conclusion: An electronic medical record-based, easily derived ERA index might be useful in hip fracture risk stratification.

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“…Osteoporosis in men is more likely to be a marker of a systemic disease. While secondary causes for osteoporosis exist in 20% to 40% of women, 65% of men who have osteoporosis have other contributory diseases [15,16,38]. These secondary causes should raise concern on the part of the clinician to evaluate and treat the underlying disease process, which can include autoimmune diseases, such as rheumatoid arthritis, alcoholism, excessive smoking, and gonadal deficiencies, among others [25].…”

Section: Pathophysiology Of Osteoporosismentioning

confidence: 99%

Sex and Gender Considerations in Male Patients With Osteoporosis

LaMont

Ton

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Osteoporosis remains underrecognized and undertreated in both men and women, but men who sustain fragility fractures experience greater morbidity and mortality. While men exhibit advanced comorbidity at the time of hip fracture presentation, there are distinct sex-and gender-specific factors related to the pathophysiology and treatment of osteoporosis that further influence morbidity and mortality. Questions/purposes With a selective review of the literature, we evaluated sex-and gender-based differences contributing to increased morbidity and mortality in men with osteoporosis.

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Risk factors for osteoporotic fractures in elderly men

Cited by 90 publications

References 27 publications

Functional limitations and poor physical performance as independent risk factors for self-reported fractures in older persons

Functional limitations and poor physical performance as independent risk factors for self-reported fractures in older persons

The Elders Risk Assessment Index, an Electronic Administrative Database–Derived Frailty Index, Can Identify Risk of Hip Fracture in a Cohort of Community-Dwelling Adults

Sex and Gender Considerations in Male Patients With Osteoporosis

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