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Residual lifetime risk of fractures in women and men.
J Bone Miner Res 2007; 22(6):781-8JB

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.

Authors+Show Affiliations

Bone and Mineral Research Program, Garvan Institute of Medical Research, St Vincent's Hospital, Sydney, New South Wales, Australia.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17352657

Citation

Nguyen, Nguyen D., et al. "Residual Lifetime Risk of Fractures in Women and Men." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 22, no. 6, 2007, pp. 781-8.
Nguyen ND, Ahlborg HG, Center JR, et al. Residual lifetime risk of fractures in women and men. J Bone Miner Res. 2007;22(6):781-8.
Nguyen, N. D., Ahlborg, H. G., Center, J. R., Eisman, J. A., & Nguyen, T. V. (2007). Residual lifetime risk of fractures in women and men. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 22(6), pp. 781-8.
Nguyen ND, et al. Residual Lifetime Risk of Fractures in Women and Men. J Bone Miner Res. 2007;22(6):781-8. PubMed PMID: 17352657.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Residual lifetime risk of fractures in women and men. AU - Nguyen,Nguyen D, AU - Ahlborg,Henrik G, AU - Center,Jacqueline R, AU - Eisman,John A, AU - Nguyen,Tuan V, PY - 2007/3/14/pubmed PY - 2007/8/30/medline PY - 2007/3/14/entrez SP - 781 EP - 8 JF - Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research JO - J. Bone Miner. Res. VL - 22 IS - 6 N2 - UNLABELLED: 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. SN - 0884-0431 UR - https://www.unboundmedicine.com/medline/citation/17352657/Residual_lifetime_risk_of_fractures_in_women_and_men_ L2 - https://doi.org/10.1359/jbmr.070315 DB - PRIME DP - Unbound Medicine ER -