Health & Environmental Research Online (HERO)


Print Feedback Export to File
3207586 
Journal Article 
Risk Factors for Hip Fracture in Older Men: The Osteoporotic Fractures in Men Study (MrOS) 
Cauley, JA; Cawthon, PM; Peters, KE; Cummings, , SR; Ensrud, KE; Bauer, DC; Taylor, BC; Shikany, JM; Hoffman, AR; Lane, NE; Kado, DM; Stefanick, ML; Orwoll, ES; Osteoporotic Fractures in Men (MrOS) Study Research Group 
2016 
Yes 
Journal of Bone and Mineral Research
ISSN: 0884-0431
EISSN: 1523-4681 
English 
26988112 
Almost 30% of hip fractures occur in men; the mortality, morbidity and loss of independence after hip fractures are greater in men than women. To comprehensively evaluate risk factors for hip fracture in older men, we performed a prospective study of 5,994 men, primarily Caucasian, age 65+ recruited at 6 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, 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 (Caucasian women reference database) who also had 4+ risk factors, 33.4. Men age >80 with 3+ major comorbidities experienced hip fracture at rates of 14.52 vs 0.88 per 1000 PY in men age <70 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. This article is protected by copyright. All rights reserved.