OBJECTIVES: To determine whether the association between change in bone mass density (BMD) over 4 years and risk of hip and nonvertebral fracture differs according to an individual's history of falls. DESIGN: Population-based cohort study. SETTING: Framingham, Massachusetts. PARTICIPANTS: Individuals with two measures of BMD at the femoral neck (mean age 78.8; 310 male, 492 female). MEASUREMENTS: Cox proportional hazards models were used to estimate hazard ratios (HRs) for the association between percentage change in BMD (per sex-specific standard deviation) and risk of incident hip and nonvertebral fracture. Models were stratified based on history of falls (≥1 falls in the past year) and recurrent falls (≥2 falls) ascertained at the time of the second BMD test. Interactions were tested by including the term "fall history * change in BMD" in the models. RESULTS: Mean change in BMD was -0.6%/year; 27.8% of participants reported falls, and 10.8% reported recurrent falls. Seventy-six incident hip and 175 incident nonvertebral fractures occurred over a median follow-up of 9.0 years. There was no difference in the association between change in BMD and hip fracture according to history of falls (P for interaction = .57). The HR associated with change in BMD and nonvertebral fracture was 1.31 (95% confidence interval (CI) = 1.10-1.56) in participants without a history of falls and 0.95 (95% CI 0.70-1.28) in those with a fall (interaction P = .07). Results for recurrent fallers were similar. CONCLUSION: The effect of BMD loss on risk of nonvertebral fracture may be greater in persons without a history of falls. It is possible that change in BMD contributes less to fracture risk when a strong risk factor for fracture, such as falls, is present.
OBJECTIVES: To determine whether the association between change in bone mass density (BMD) over 4 years and risk of hip and nonvertebral fracture differs according to an individual's history of falls. DESIGN: Population-based cohort study. SETTING: Framingham, Massachusetts. PARTICIPANTS: Individuals with two measures of BMD at the femoral neck (mean age 78.8; 310 male, 492 female). MEASUREMENTS: Cox proportional hazards models were used to estimate hazard ratios (HRs) for the association between percentage change in BMD (per sex-specific standard deviation) and risk of incident hip and nonvertebral fracture. Models were stratified based on history of falls (≥1 falls in the past year) and recurrent falls (≥2 falls) ascertained at the time of the second BMD test. Interactions were tested by including the term "fall history * change in BMD" in the models. RESULTS: Mean change in BMD was -0.6%/year; 27.8% of participants reported falls, and 10.8% reported recurrent falls. Seventy-six incident hip and 175 incident nonvertebral fractures occurred over a median follow-up of 9.0 years. There was no difference in the association between change in BMD and hip fracture according to history of falls (P for interaction = .57). The HR associated with change in BMD and nonvertebral fracture was 1.31 (95% confidence interval (CI) = 1.10-1.56) in participants without a history of falls and 0.95 (95% CI 0.70-1.28) in those with a fall (interaction P = .07). Results for recurrent fallers were similar. CONCLUSION: The effect of BMD loss on risk of nonvertebral fracture may be greater in persons without a history of falls. It is possible that change in BMD contributes less to fracture risk when a strong risk factor for fracture, such as falls, is present.
Authors: S Kaptoge; L I Benevolenskaya; A K Bhalla; J B Cannata; S Boonen; J A Falch; D Felsenberg; J D Finn; R Nuti; K Hoszowski; R Lorenc; T Miazgowski; I Jajic; G Lyritis; P Masaryk; M Naves-Diaz; G Poor; D M Reid; C Scheidt-Nave; J J Stepan; C J Todd; K Weber; A D Woolf; D K Roy; M Lunt; S R Pye; T W O'neill; A J Silman; J Reeve Journal: Bone Date: 2005-03 Impact factor: 4.398
Authors: Steven Boonen; Fernando Marin; Dan Mellstrom; Li Xie; Durisala Desaiah; John H Krege; Clifford J Rosen Journal: J Am Geriatr Soc Date: 2006-05 Impact factor: 5.562
Authors: Yu Z Bagger; László B Tankó; Peter Alexandersen; Henrik B Hansen; Gerong Qin; Claus Christiansen Journal: Osteoporos Int Date: 2005-10-28 Impact factor: 4.507
Authors: S D Berry; D P Kiel; M G Donaldson; S R Cummings; J A Kanis; H Johansson; E J Samelson Journal: Osteoporos Int Date: 2010-01 Impact factor: 4.507
Authors: Katie L Stone; Dana G Seeley; Li-Yung Lui; Jane A Cauley; Kristine Ensrud; Warren S Browner; Michael C Nevitt; Steven R Cummings Journal: J Bone Miner Res Date: 2003-11 Impact factor: 6.741
Authors: Robert Wilk; Michał Skrzypek; Małgorzata Kowalska; Damian Kusz; Bogdan Koczy; Piotr Zagórski; Wojciech Pluskiewicz Journal: Aging Clin Exp Res Date: 2016-09-06 Impact factor: 3.636