Relations of osteoporosis and follow-up duration to recurrent falls in older men and women

Summary

There were differences in risk factors between men and women and between two follow-up time lengths. Osteoporosis was significantly associated with recurrent falls for women but not for men. The relationship of osteoporosis with falls in the past year decreased during follow-up, while those of sedatives and hypnotics remained.

Introduction

A prospective study to investigate relationships between osteoporosis and recurrent falls at two follow-up lengths of 6 and 12 months in older men and women.

Methods

In total, 204 men and 447 women who visited an emergency department due to a fall were recruited.

Results

For men, the risk of falling was not significantly associated with osteoporosis at 6 or 12 months. Men with a fall history were 127 and 100 %, respectively, more likely to have a fall at 6 and 12 months than those without. Men who did not use walking aids were 97 % more likely to have a fall at 12 months than those who did. Women with osteoporosis were 246 and 104 %, respectively, more likely to have a fall at 6 and 12 months than those without. Women with a fall history were 129 and 66 %, respectively, more likely to have a fall at 6 and 12 months than those without. Women taking sedatives and hypnotics were 75 and 102 %, respectively, more likely to have a fall at 6 and 12 months than their counterparts. Women with depression were 138 % more likely to have a fall at 6 months and those using walking aids were 59 % more likely to have a fall at 12 months, compared to their counterparts.

Conclusions

Osteoporosis is association with falls for older women but not for older men. Identifying risk factors for recurrent falls in older people may be affected by the follow-up length, as their associations are reduced over time.     

Female gender is a risk factor for pain, discomfort, and fatigue after laparoscopic groin hernia repair

Purpose

Female gender is a risk factor for early pain after several specific surgical procedures but has not been studied in detail after laparoscopic groin hernia repair. The aim of this study was to compare early postoperative pain, discomfort, fatigue, and nausea and vomiting between genders undergoing laparoscopic groin hernia repair.

Methods

Prospective consecutive enrollment of women and age-matched (±1 year) and uni-/bilateral hernia-matched male patients undergoing elective transabdominal preperitoneal hernia repair (TAPP). Patients in the two groups received a similar anesthetic, surgical, and analgesic treatment protocol.

Results

Between August 2009 and August 2010, 25 women and 25 men undergoing elective TAPP were prospectively included in the analysis (n = 50) with no significant difference between groups in psychological status regarding anxiety, depression, and catastrophizing. On day 0, women had significantly more pain during rest (p = 0.015) and coughing (p = 0.012), discomfort (p = 0.001), and fatigue (0.020) compared with men. Additionally, cumulative overall postoperative pain during coughing, discomfort, and fatigue on day 0–3 was significantly higher in women compared with men (all p values < 0.05). Women required significantly more opioids (p = 0.015) and had a significantly higher incidence of vomiting on days 0 and 1 (p = 0.002).

Conclusions

Women experienced more pain, discomfort, and fatigue compared with men after laparoscopic groin hernia repair.

Trial registration

Registration number NCT00962338 (www.clinicaltrials.gov).     

Health-related quality of life with vertebral fracture, lumbar spondylosis and knee osteoarthritis in Japanese men: the ROAD study

Summary

This study examined associations of VFx, lumbar spondylosis and knee OA with QOL in 767 men over 40 years old from the ROAD study (mean, 69.7 years.). Multiple regression analysis showed VFx and knee OA as significantly associated with lower PCS scores, but lumbar spondylosis was not.

Purpose

Little data have been accumulated regarding associations of vertebral fracture (VFx), lumbar spondylosis and knee osteoarthritis (OA) with quality of life (QOL) in men. The purpose of the present study is to clarify the impact of these diseases on QOL parameters such as the Medical Outcomes Study Short Form 8 (SF-8) and the EuroQOL (EQ-5D). In addition, to provide greater insight into the magnitude of QOL loss, a comparison was made with cerebral stroke.

Methods

From the 3,040 participants in the ROAD study, this study analyzed 767 men over 40 years who had completed the questionnaires (mean, 69.7 years.). Vertebral fracture was assessed by lateral radiography of the lumbar spine. Lumbar spondylosis and knee OA were defined as Kellgren/Lawrence grade ≥3. Cerebral stroke was assessed by self-report.

Results

Multiple regression analysis after adjustments for age, body mass index and presence of the above four diseases showed VFx was significantly associated with lower scores in physical function (PF), role physical (RP), bodily pain (BP) and vitality (VT) domains as well as physical component summary (PCS). Knee OA were significantly associated with lower scores in PF, RP, BP and PCS scores. Lumbar spondylosis was not associated with any domains of the SF-8. Lumbar spondylosis and knee OA were significantly associated with EQ-5D utility scores, but VFx was not. The impact for VFx on BP, VT and PCS scores was larger than cerebral stroke.

Conclusions

This study revealed that VFx and knee OA impaired physical QOL in men, rather than lumbar spondylosis.     

Prevalence of osteoporotic fracture risk factors and antiosteoporotic treatments in the Valencia region, Spain. The baseline characteristics of the ESOSVAL cohort

Summary

This study provides information on the prevalence of the most important risk factors for osteoporosis and osteoporotic fracture in a large sample of women and men from the Valencia region and also provides the FRAX 10-year major and hip fracture risks for this population, as well as data about the use of diagnostic tests and antiosteoporotic treatments.

Introduction

The purpose of this study was to describe demographic characteristics, osteoporosis risk factors, the 10-year risk of osteoporotic fracture, and the use of densitometry and antiosteoporotic treatments in the Valencia region, Spain.

Methods

A cross-sectional study using the ESOSVAL cohort baseline data was conducted. We analyze the data from 5,310 women and 5,725 men aged 50 and over who attended to 272 collaborating primary care centers in 2009–2010. We collected the demographic, anthropometric, clinical, and pharmacy data from the electronic medical record.

Results

The mean age of participants was 64.3 years old for women and 65.6 years old for men. The most frequent fracture risk factors were sedentary life (22.2 %) and previous fracture (15.8 %) in women and low calcium intake (21.4 %) and current smoker (20.9 %) in men. According to FRAX^®, the 10-year risk of presenting a major fracture was 5.5 % for the women and 2.8 % for the men. The 10-year risk for hip fracture was 1.9 and 1.1 % for the women and the men, respectively; 23.8 % of the women and 5.2 % of the men had a densitometry test, 27.7 % of the women and 3.5 % of the men were taking calcium and/or vitamin D supplements, and 28.2 % of the women (22.0 % in the 50–64 age group) and 2.3 % of the men were taking antiosteoporotic drugs.

Conclusions

The prevalence of certain fracture risk factors not included in the FRAX tool (sedentary life, falls, low calcium intake) is high. In young women, their low risks estimated by FRAX contrast with the high figures for densitometry testing and treatment.     

Fall-related risk factors and heel quantitative ultrasound in the assessment of hip fracture risk: a 10-year follow-up of a nationally representative adult population sample

Summary

Maximal walking speed and quantitative ultrasound index (QUI) were significant and independent predictors of hip fracture among subjects aged ≥55 years. A model including readily available variables along with simple fall-related factors may be clinically useful in the assessment of hip fracture risk even without a QUI measurement.

Introduction

This study assessed fall-related risk factors along with heel bone quantitative ultrasound (QUS) measurements for the prediction of hip fracture during a mean follow-up of 9.8 years in a nationally representative population sample.

Methods

The study population consisted of 2,300 subjects (1,331 women and 969 men) aged 55 years or over, who had participated in a comprehensive health survey in 2000–2001. Information on the subjects’ health and fall-related risk factors was obtained with interviews, questionnaires and tests carried out by specially trained professionals. QUS measurements were made by means of the Hologic Sahara device. First emerging cases of hip fracture were identified from the National Hospital Discharge Register.

Results

During the follow-up, 96 subjects sustained a hip fracture. Slow maximal walking speed, low quantitative ultrasound index (QUI), high age, tallness, short waist circumference, Parkinson’s disease and the number of central nervous system active medication were significant and independent predictors of hip fracture. The model including all of these risk factors explained 68 % of the variation in hip fracture risk. Excluding QUI from this model reduced the percentage to 66 %.

Conclusions

Maximal walking speed and QUI were significant and independent predictors of hip fracture. A model including readily available variables such as age, gender, height and waist circumference along with simple fall-related factors may be of clinical use in the assessment of hip fracture risk even without a QUS measurement.     

Risk factors for falls in a longitudinal population-based cohort study of Japanese men and women: The ROAD Study

The objective of this study was to clarify the associations of physical performance and bone and joint diseases with single and multiple falls in Japanese men and women using a population-based longitudinal cohort study known as Research on Osteoarthritis/osteoporosis Against Disability (ROAD). A total of 452 men and 896 women were analyzed in the present study (mean age, 63.9 years). A questionnaire was used to assess the number of falls during the 3-year follow-up. Grip strength, 6-m walking time, and chair stand time were measured at baseline. Knee osteoarthritis (OA) and lumbar spondylosis were defined as Kellgren Lawrence = 2, 3 or 4. Vertebral fracture (VFx) was assessed with the Japanese Society of Bone and Mineral Research criteria. Osteoporosis was defined by bone mineral density using dual energy X-ray absorptiometry based on World Health Organization criteria. Knee and lower back pain were estimated by an interview. During a 3-year follow-up, 79 (17.4%) men and 216 (24.1%) women reported at least one fall, and 54 (11.9%) men and 111 (12.4%) women reported multiple falls. Knee pain was a risk factor for multiple falls in women, but not in men. VFx tended to be associated with multiple falls in women, but not in men. A longer 6-m walking time was a risk factor for multiple falls in women, whereas a longer chair stand time was a risk factor for multiple falls in men. We found gender differences in risk factors for falls.     

Operational definitions of sarcopenia and their associations with 5-year changes in falls risk in community-dwelling middle-aged and older adults

Summary

Sarcopenia may be diagnosed in the clinic using operational definitions based on low muscle mass or function. This prospective, population-based study revealed that sex-specific associations may exist between operational definitions of sarcopenia and falls in community-dwelling middle-aged and older adults.

Introduction

The objective of this study is to verify associations between sarcopenia and falls risk and to determine changes in sarcopenia prevalence over 5 years in middle-aged and older men and women according to different anthropometric and performance-based operational definitions.

Methods

N?=?681 volunteers (48 % female; mean?±?SD age 61.4?±?7.0 years) participated in baseline and follow-up assessments (mean 5.1?±?0.5 years later). Appendicular lean mass (ALM) was assessed by dual-energy X-ray absorptiometry, hand grip (HGS) and lower-limb (LLS) strength were assessed by dynamometry, and falls risk was determined using the physiological profile assessment. Anthropometric definitions (ALM/height squared [ALM–H], ALM/weight × 100 and a residuals method [ALM–R]) and performance-based definitions (HGS, LLS and upper- and lower-limb muscle quality [LMQ]) of sarcopenia were examined. The lowest 20 % of the sex-specific distribution for each definition at baseline was classified as sarcopenia.

Results

Sarcopenia prevalence increased after 5 years for all operational definitions except ALM–H (men: ?4.0 %; women: ?5.5 %). Men classified with sarcopenia according to anthropometric definitions, and women classified with sarcopenia according to performance-based definitions, had significant increases in falls risk over 5 years (all P?<?0.05) compared to individuals without sarcopenia. Significant sex interactions were observed for ALM-R, LLS and LMQ (all P?<?0.05) definitions.

Conclusions

Sarcopenia prevalence generally increases at a higher rate when assessed using performance-based definitions. Sarcopenia is associated with increases in falls risk over 5 years in community-dwelling middle-aged and older adults, but sex-specific differences may exist according to different anthropometric or performance-based definitions.     

Exercise habits during middle age are associated with lower prevalence of sarcopenia: the ROAD study

Summary

The present cross-sectional study investigated the prevalence of sarcopenia and clarified its associated factors in 1,000 elderly participants of Japanese population-based cohorts. Exercise habit in middle age was associated with low prevalence of sarcopenia in older age, suggesting that it is a protective factor against sarcopenia in older age.

Introduction

The present study investigated the prevalence of sarcopenia using the European Working Group on Sarcopenia in Older People (EWGSOP) definition, and clarified the association of sarcopenia with physical performance in the elderly participants of Japanese population-based cohorts of the Research on Osteoarthritis/osteoporosis Against Disability (ROAD) study.

Methods

We enrolled 1,000 participants (aged ≥65 years) from the second visit of the ROAD study who had completed assessment of handgrip strength, gait speed, and skeletal muscle mass measured by bioimpedance analysis. Presence of sarcopenia was determined according to the EWGSOP algorithm. Information collected included exercise habits in middle age.

Results

Prevalence of sarcopenia was 13.8 % in men and 12.4 % in women, and tended to be significantly higher according to increasing age in both sexes. Factors associated with sarcopenia, as determined by logistic regression analysis, were chair stand time (odds ratio [OR], 1.09; 95 % confidence interval [CI], 1.04–1.14), one-leg standing time (OR, 0.97; 95 % CI, 0.96–0.99), and exercise habit in middle age (OR, 0.53; 95 % CI, 0.31–0.90). Exercise habit in middle age was associated with low prevalence of sarcopenia in older age. Furthermore, linear regression analysis revealed that exercise habits in middle age were significantly associated with grip strength (P?<?.001), gait speed (P?<?.001), and one-leg standing time (P?=?.005) in older age.

Conclusions

This cross-sectional study suggests that exercise habit in middle age is a protective factor against sarcopenia in older age and effective in maintaining muscle strength and physical performance in older age.     

Percentage of the population at high risk of osteoporotic fracture in South Korea: analysis of the 2010 Fifth Korean National Health and Nutrition Examination survey data

Summary

Osteoporosis and high-risk osteopenia (high-risk of osteoporotic fractures) are highly prevalent in South Korean postmenopausal women and men aged 50 years and over.

Introduction

This study determined the percentages of the population at high risk of osteoporotic fractures according to the World Health Organization (WHO) criteria and the Fracture Risk Assessment (FRAX) model.

Methods

Data collected from the 2010 Fifth Korean National Health and Nutrition Examination Survey, a cross-sectional survey of the general South Korean general population, were analyzed. The percentages of the population with high-risk osteopenia according to the US National Osteoporosis Foundation (NOF) and Japanese treatment guidelines were subsequently determined and compared.

Results

Based on the WHO criteria and FRAX model, 37.7 % of the menopausal women and 12.7 % of the men aged 50 years and older are at high risk of osteoporotic fracture. According to the Japanese and NOF guidelines, 10.9 (10.6 % of men and 11.2 % of women) and 10.7 % (10.6 % of men and 10.9 % of women), respectively, of the study population with osteopenia are at high risk of fracture. By age group, 49.3 % of Korean women aged 55 years and older, 67.7 % of Korean women aged 65 years and older, and 33.5 % of Korean men aged 75 years and older are at high risk.

Conclusion

As a very large percentage of the South Korean postmenopausal population has osteoporosis or high-risk osteopenia, greater effort at identifying and treating this population should be expended to prevent osteoporotic fracture.     

Prevalence and risk factors of radiographic vertebral fractures in elderly Chinese men and women: results of Mr. OS (Hong Kong) and Ms. OS (Hong Kong) studies

Summary

This study investigated the prevalence of radiographic vertebral fractures using Genant’s semiquantitative (SQ) scoring system in elderly Chinese men (n?=?2,000; mean age, 72.4 years) and women (n?=?2,000; mean age, 72.6 years). Vertebral deformities had similar prevalence in elderly men (14.9 %) and women (16.5 %). Majority of the deformities in men were mild (9.9 %, grade?=?1). The prevalence of vertebral fractures (grade?≥?2) was 5.0 % among men and 12.1 % among women.

Introduction

Vertebral fracture is a serious consequence of osteoporosis and is often under-diagnosed. Researches on different ethnicities and territories to estimate the prevalence of vertebral fractures and to identify the risk factors are necessary.

Methods

Mr. OS (Hong Kong) and Ms. OS (Hong Kong) represent the first large-scale cohort studies ever conducted on bone health in elderly Chinese men (n?=?2,000) and women (n?=?2,000). The current study investigated the prevalence of radiographic vertebral fractures in these subjects using Genant’s SQ scoring system and identified risk factors for vertebral fractures.

Results

The radiographs of all men (mean age, 72.4 years) and women (mean age, 72.6 years) were obtained. Six hundred twenty-seven subjects (15.7 %) had at least one vertebral deformity (SQ grade?≥?1), including 297 men (14.9 %) and 330 women (16.5 %, p?=?0.151). Three hundred forty-two participants (8.6 %) were defined as having at least one vertebra fracture (SQ grade?≥?2), consisted of 100 men (5.0 %) and 242 women (12.1 %, p?<?0.001). Older age, lower bone mineral density, lower physical activity, lower grip strength, fracture history, and low back pain were significantly associated with higher vertebral fracture rate for both men and women.

Conclusion

Vertebral deformity had similar prevalence in older men and women, while vertebral fracture was more common in women. Majority of deformities in men was mild. The vertebral deformity prevalence of women from this study is similar to previous reports of other East Asian women and Latin American women.     

Why not use your own body weight to prevent falls? A randomized,controlled trial of balance therapy to prevent falls and fractures for elderly people who can stand on one leg for ≤15 s

Background

Maintaining or improving motor (balance) ability is essential to extending the healthy lifespan of elderly people, and developing effective and efficient strategies to prevent falls of elderly people is an urgent. The purpose of this study was to determine the effects of balance exercise on fall and fracture prevention for elderly people with poor balance.

Methods

A 6-month, randomized controlled trial was conducted to verify whether one-leg standing with eyes open for a total of 1 min, three times a day (dynamic flamingo exercise) prevents falls and fractures. Setting and participants were elderly people ≥75 years of age and one-leg standing time ≤15.0 s living in their own home. They were visiting orthopaedic clinics for orthopaedic handicaps. Subjects with poor balance were allowed to hold on to something. If a subject’s lifted leg touched the ground during the exercise, they were allowed to lift it again and continue so that they stood on one leg for a total of 60 s.

Results

The dynamic flamingo exercise group (410 people; 86 men, 324 women) and the no exercise group (455 people; 78 men, 377 women) were compared. After dynamic flamingo exercise for 6 months, significant differences were seen in the increase in one-leg standing time with eyes open (men right/left, women right/left), in the improvement in independence in daily living (women), number of people who fell during the 6 months (women), and adverse events (women). The number of fractures was not significantly different for men or women.

Conclusions

Dynamic flamingo exercise prevents falls but no significant difference was demonstrated in fracture prevention in elderly women with poor balance.     

All-cause and cause-specific mortality after hip fracture among Chinese women and men

Summary

All-cause mortality risk persisted for 5 years after hip fractures in both men and women. There may be gender-specific differences in effect and duration of excess risk for cause-specific mortality after hip fracture.

Introduction

To determine all-cause and cause-specific mortality risk in the first 5 years after hip fracture in an Asian Chinese population.

Methods

The Singapore Chinese Health Study is a population-based cohort of 63,257 middle-aged and elderly Chinese men and women in Singapore recruited between 1993 and 1998. This cohort was followed up for hip fracture and death via linkage with nationwide hospital discharge database and death registry. As of 31 December 2008, we identified 1,166 hip fracture cases and matched five non-fracture cohort subjects by age and gender for each fracture case. Cox proportional hazards and competing risks regression models with hip fracture as a time-dependent covariate were used to determine all-cause and cause-specific mortality risk, respectively.

Results

Increase in all-cause mortality risk persisted till 5 years after hip fracture (adjusted hazard ratio, aHR = 1.58 [95 % CI, 1.35–1.86] for females and aHR = 1.64 [95 % CI, 1.30–2.06] for males). Men had higher mortality risk after hip fracture than women for deaths from stroke and cancer up to 1 year post-fracture but women with hip fracture had higher coronary artery mortality risk than men for 5 years post-fracture. Men had higher risk of death from pneumonia while women had increased risk of death from urinary tract infections. There was no difference in mortality risk by types of hip fracture surgery.

Conclusions

All-cause mortality risk persisted for 5 years after hip fractures in men and women. There are gender-specific differences in effect size and duration of excess mortality risk from hip fractures between specific causes of death.     

Association between coronary artery calcification using low-dose MDCT coronary angiography and bone mineral density in middle-aged men and women

Summary

Six hundred sixty-one participants who had at least one cardiac risk factor but were without known coronary heart disease underwent low-dose multidetector computed tomography coronary angiography (MDCT-CA) and dual-energy X-ray absorptiometry. The association between presence of subclinical coronary calcified plaque and low bone mineral density for the middle-aged individual was not significant after multivariate adjustment.

Introduction

Results of previous clinical studies assessing the relationship between osteoporosis and coronary calcification are inconsistent. This study aimed to evaluate the association between subclinical coronary calcification and osteoporosis in middle-aged men, premenopausal women, and postmenopausal women by using low-dose MDCT-CA and bone mineral density (BMD).

Methods

This study enrolled 661 participants with at least one cardiac risk factor but without known coronary artery disease (CAD). All subjects underwent low-dose MDCT-CA and dual-energy X-ray absorptiometry on the same day.

Results

The mean age was 52.2 years for men, 44.8 years for premenopausal women, and 59.1 years for postmenopausal women. The prevalence of calcified plaques between men with normal BMD and low BMD at lumbar spine were significantly different (P?=?0.042). The prevalence of mixed plaque and calcified plaque between pre- and postmenopausal women with normal BMD and low BMD at lumbar spine and femoral neck were not significantly different (P?>?0.05). Possible association between lumbar spine, femoral neck, and total proximal femur BMD and the presence of CAP was evaluated for men, premenopausal women, and postmenopausal women using multivariate logistic regression analysis: results were not significant (P?>?0.05).

Conclusion

Our study demonstrates that the association between the presence of subclinical coronary calcification and low BMD among middle-aged men and women was not significant after controlling for age and other risk factors for CAD and osteoporosis.     

Association between hypertension and fragility fracture: a longitudinal study

Summary

Hypertension is an independent risk factor for osteoporosis and osteoporotic fracture in postmenopausal women.

Introduction

Although hypertension has been suggested to be associated with increased fracture risk, it is not clear whether the association is independent of bone mineral density (BMD). The present study sought to examine the interrelationships between hypertension, BMD, and fracture risk.

Methods

The study included 1,032 men and 1,701 women aged 50 years and older who were participants in the Dubbo Osteoporosis Epidemiology Study. BMD at the femoral neck and lumbar spine was measured by dual energy X-ray absorptiometry (GE-LUNAR Corp., Madison, WI, USA). The presence of hypertension was ascertained by direct interview and verification through clinical history. The incidence of fragility fractures was ascertained by X-ray report during the follow-up period (1989–2008). The Cox proportional hazards model was used to assess the association between hypertension and fracture risk.

Results

Women with hypertension had lower BMD at the femoral neck (0.79 versus 0.82 g/cm², P?=?0.02) than those without the disease. After adjusting for BMD and covariates, hypertension was an independent risk factor for fragility fracture [hazard ratio (HR), 1.49; 95 % CI, 1.13–1.96]. In men, hypertension was associated with higher femoral neck BMD (0.94 versus 0.92 g/cm², P?=?0.02), but the association between hypertension and fracture risk did not reach statistical significance.

Conclusion

Hypertension is associated with increased fracture risk in women, and the association is independent of BMD.     

Schmerzchronifizierung, Geschlecht und Rehabilitationserfolg bei chronischem Rückenschmerz

Background

Current biopsychosocial models of the etiology and chronicity of back pain postulate a major impact of psychological factors in the process of back pain chronicity.

Participants and methods

Effects of gender and pain staging on rehabilitation outcome were examined immediately after and 3 and 6 months after rehabilitation in 121 patients with chronic low back pain (43 women, 78 men; M=48 years; ICD-10 diagnoses M54.4/M54.5). Pain was staged using the Mainz Pain Staging System.

Results

In the short and mid term, patients in stage I and women benefited from rehabilitation. Rehabilitation outcomes tended not to be improved for men in stage III.

Conclusions

Results support the notion that rehabilitation outcome is significantly influenced by pain staging and gender. Thus, clinical–psychological and gender-specific interventions should be incorporated in future therapeutic regimens to increase the rehabilitation outcomes in patients with higher chronicity of back pain.     

Albuminuria is associated with hip fracture risk in older adults: the cardiovascular health study

Summary

The microcirculation plays an important role in bone health. Here, we examine whether albuminuria, a marker of renal microvascular disease, is associated with the risk of hip fracture in older adults (age, 78 years). We find a small independent association in women but not in men.

Introduction

The microvascular circulation plays an important role in bone physiology. Two studies of middle-aged adults have found that albuminuria (>30 mg albumin/g creatinine), a disorder of the renal microvasculature, is associated with fracture risk. Here, we examine whether albuminuria is related to hip fracture risk and reduced hip bone mineral density (BMD) in older adults with a mean age of 78 years.

Methods

From the Cardiovascular Health Study (41 % male), 3,110 adults with albuminuria testing were followed up for incident hip fracture for up to 9.5 years. BMD was performed in a subset of 1,208 participants.

Results

There were 313 hip fractures during follow-up (7.7 % of men; 11.7 % of women). The incidence rate for men, with and without albuminuria, was 1.43 and 0.93/100 person-years of follow-up (p?=?0.02); for women, 1.84 and 1.33 (p?=?0.04). After adjustment for osteoporosis-related factors, frailty and falling, a doubling of albuminuria was significantly associated with hip fracture risk in women (hazard ratio, 1.12, 95 % CI, 1.001–1.25), but not in men. In the subcohort with BMD measurement, increased urine albumin levels were significantly associated with decreased total hip BMD in men (?0.009 g calcium/cm² (?0.017, ?0.001); p?=?0.04), but not in women.

Conclusions

In older women, albuminuria is associated with a small, but statistically significant, increased risk of hip fracture independent of other explanatory factors. No such risk appears to be present in men, although their total hip BMD is lower in association with albuminuria.