Residual Lifetime Risk of Fractures in Women and Men.
From: Bone and Mineral Research Program, Garvan Institute of Medical Research, St Vincent’s Hospital, Sydney, New South Wales, Australia.
Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
- Publish Date: Jun 2007
- ISSN: 0884-0431
- Volume: 22
- Issue: 6
- Pages: 781-8
- Medium: Print
- Language: English
- Citation (JAMA): Nguyen Nguyen D, Ahlborg Henrik G, Center Jacqueline R, et al. Residual Lifetime Risk of Fractures in Women and Men.. J. Bone Miner. Res. Jun 2007;22:781-8
Abstract
In a sample of 1358 women and 858 men, > or = 60 yr of age who have been followed-up for up to 15 yr, it was estimated that the mortality-adjusted residual lifetime risk of fracture was 44% for women and 25% for men. Among those with BMD T-scores < or = -2.5, the risks increased to 65% in women and 42% in men. INTRODUCTION: Risk assessment of osteoporotic fracture is shifting from relative risk to an absolute risk approach. Whereas BMD is a primary predictor of fracture risk, there has been no estimate of mortality-adjusted lifetime risk of fracture by BMD level. The aim of the study was to estimate the residual lifetime risk of fracture (RLRF) in elderly men and women. MATERIALS AND METHODS: Data from 1358 women and 858 men > or = 60 yr of age as of 1989 of white background from the Dubbo Osteoporosis Epidemiology Study were analyzed. The participants have been followed for up to 15 yr. During the follow-up period, incidence of low-trauma, nonpathological fractures, confirmed by X-ray and personal interview, were recorded. Incidence of mortality was also recorded. BMD at the femoral neck was measured by DXA (GE-LUNAR) at baseline. Residual lifetime risk of fracture from the age of 60 was estimated by the survival analysis taking into account the competing risk of death. RESULTS: After adjusting for competing risk of death, the RLRF for women and men from age 60 was 44% (95% CI, 40-48) and 25% (95% CI, 19-31), respectively. For individuals with osteoporosis (BMD T-scores < or = -2.5), the mortality-adjusted lifetime risk of any fracture was 65% (95% CI, 58-73) for women and 42% (95% CI, 24-71) for men. For the entire cohort, the lifetime risk of hip fracture was 8.5% (95% CI, 6-11%) for women and 4% (95% CI, 1.3-5.4%) for men; risk of symptomatic vertebral fracture was 18% (95% CI, 15-21%) for women and 11% (95% CI, 7-14%) for men. CONCLUSIONS: These estimates provide a means to communicate the absolute risk of fracture to an individual patient and can help promote the identification and targeting of high-risk individuals for intervention.
Mesh Headings (Keywords): Age Factors, Aged, Aged, 80 and over, Bone Density, Bone Diseases, Metabolic, Female, Fractures, Bone, Hip Fractures, Humans, Male, Middle Aged, New South Wales, Osteoporosis, Osteoporosis, Postmenopausal, Risk Assessment, Risk Factors, Sex Factors, Spinal Fractures, Survival Analysis
Check for Full Text / PubMed Unique Identifier (PMID): 17352657
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The data herein was last updated on July 8th, 2008 and may not reflect the most current and accurate data available from NLM.