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Older men who sustain a hip fracture experience greater declines in bone mineral density at the contralateral hip than non-fractured comparators.
Osteoporos Int. 2018 02; 29(2):365-373.OI

Abstract

Men experience declining bone mineral density (BMD) after hip fracture; however, changes attributable to fracture are unknown. This study evaluated the excess BMD decline attributable to hip fracture among older men. Older men with hip fracture experienced accelerated BMD declines and are at an increased risk of secondary fractures.

INTRODUCTION

The objective was to determine whether bone mineral density (BMD) changes in men after hip fracture exceed that expected with aging.

METHODS

Two cohorts were used: Baltimore Hip Studies 7th cohort (BHS-7) and Baltimore Men's Osteoporosis Study (MOST). BHS-7 recruited older adults (N = 339) hospitalized for hip fracture; assessments occurred within 22 days of admission and at 2, 6, and 12 months follow-up. MOST enrolled age-eligible men (N = 694) from population-based listings; data were collected at a baseline visit and a second visit that occurred between 10 and 31 months later. The combined sample (n = 452) consisted of Caucasian men from BHS-7 (n = 89) and MOST (n = 363) with ≥ 2 dual-energy X-ray absorptiometry scans and overlapping ranges of age, height, and weight. Mixed-effect models estimated rates of BMD change, and generalized linear models evaluated differences in annual bone loss at the total hip and femoral neck between cohorts.

RESULTS

Adjusted changes in total hip and femoral neck BMD were - 4.16% (95% CI, - 4.87 to - 3.46%) and - 4.90% (95% CI, - 5.88 to - 3.92%) in BHS-7 participants; - 1.57% (95% CI, - 2.19 to - 0.96%) and - 0.99% (95% CI, - 1.88 to - 0.10%) in MOST participants; and statistically significant (P < 0.001) between-group differences in change were - 2.59% (95% CI, - 3.26 to - 1.91%) and - 3.91% (95% CI, - 4.83 to - 2.98%), respectively.

CONCLUSION

Hip fracture in older men is associated with accelerated BMD declines at the non-fractured hip that are greater than those expected during aging, and pharmacological interventions in this population to prevent secondary fractures may be warranted.

Authors+Show Affiliations

Geriatric Research Education and Clinical Center, VA Maryland Health Care System, Baltimore, MD, USA. arathbun@som.umaryland.edu. Department of Epidemiology and Public Health, University of Maryland School of Medicine, Howard Hall Suite 200, 660 W. Redwood Street, Baltimore, MD, 21201, USA. arathbun@som.umaryland.edu.Department of Epidemiology and Public Health, University of Maryland School of Medicine, Howard Hall Suite 200, 660 W. Redwood Street, Baltimore, MD, 21201, USA.Translational Gerontology Branch, National Institutes on Aging, Baltimore, MD, USA.Target Sciences Research and Development, GlaxoSmithKline, King of Prussia, PA, USA.Department of Epidemiology and Public Health, University of Maryland School of Medicine, Howard Hall Suite 200, 660 W. Redwood Street, Baltimore, MD, 21201, USA.Department of Physical Therapy, University of Delaware, Newark, DE, USA.Department of Epidemiology and Public Health, University of Maryland School of Medicine, Howard Hall Suite 200, 660 W. Redwood Street, Baltimore, MD, 21201, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

29063216

Citation

Rathbun, A M., et al. "Older Men Who Sustain a Hip Fracture Experience Greater Declines in Bone Mineral Density at the Contralateral Hip Than Non-fractured Comparators." Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, vol. 29, no. 2, 2018, pp. 365-373.
Rathbun AM, Magaziner J, Shardell MD, et al. Older men who sustain a hip fracture experience greater declines in bone mineral density at the contralateral hip than non-fractured comparators. Osteoporos Int. 2018;29(2):365-373.
Rathbun, A. M., Magaziner, J., Shardell, M. D., Yerges-Armstrong, L. M., Orwig, D., Hicks, G. E., & Hochberg, M. C. (2018). Older men who sustain a hip fracture experience greater declines in bone mineral density at the contralateral hip than non-fractured comparators. Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 29(2), 365-373. https://doi.org/10.1007/s00198-017-4280-0
Rathbun AM, et al. Older Men Who Sustain a Hip Fracture Experience Greater Declines in Bone Mineral Density at the Contralateral Hip Than Non-fractured Comparators. Osteoporos Int. 2018;29(2):365-373. PubMed PMID: 29063216.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Older men who sustain a hip fracture experience greater declines in bone mineral density at the contralateral hip than non-fractured comparators. AU - Rathbun,A M, AU - Magaziner,J, AU - Shardell,M D, AU - Yerges-Armstrong,L M, AU - Orwig,D, AU - Hicks,G E, AU - Hochberg,M C, Y1 - 2017/10/24/ PY - 2017/07/16/received PY - 2017/10/16/accepted PY - 2017/10/25/pubmed PY - 2019/2/5/medline PY - 2017/10/25/entrez KW - Aging KW - Epidemiology KW - Fracture prevention KW - Hip fracture KW - Osteoporosis SP - 365 EP - 373 JF - Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA JO - Osteoporos Int VL - 29 IS - 2 N2 - : Men experience declining bone mineral density (BMD) after hip fracture; however, changes attributable to fracture are unknown. This study evaluated the excess BMD decline attributable to hip fracture among older men. Older men with hip fracture experienced accelerated BMD declines and are at an increased risk of secondary fractures. INTRODUCTION: The objective was to determine whether bone mineral density (BMD) changes in men after hip fracture exceed that expected with aging. METHODS: Two cohorts were used: Baltimore Hip Studies 7th cohort (BHS-7) and Baltimore Men's Osteoporosis Study (MOST). BHS-7 recruited older adults (N = 339) hospitalized for hip fracture; assessments occurred within 22 days of admission and at 2, 6, and 12 months follow-up. MOST enrolled age-eligible men (N = 694) from population-based listings; data were collected at a baseline visit and a second visit that occurred between 10 and 31 months later. The combined sample (n = 452) consisted of Caucasian men from BHS-7 (n = 89) and MOST (n = 363) with ≥ 2 dual-energy X-ray absorptiometry scans and overlapping ranges of age, height, and weight. Mixed-effect models estimated rates of BMD change, and generalized linear models evaluated differences in annual bone loss at the total hip and femoral neck between cohorts. RESULTS: Adjusted changes in total hip and femoral neck BMD were - 4.16% (95% CI, - 4.87 to - 3.46%) and - 4.90% (95% CI, - 5.88 to - 3.92%) in BHS-7 participants; - 1.57% (95% CI, - 2.19 to - 0.96%) and - 0.99% (95% CI, - 1.88 to - 0.10%) in MOST participants; and statistically significant (P < 0.001) between-group differences in change were - 2.59% (95% CI, - 3.26 to - 1.91%) and - 3.91% (95% CI, - 4.83 to - 2.98%), respectively. CONCLUSION: Hip fracture in older men is associated with accelerated BMD declines at the non-fractured hip that are greater than those expected during aging, and pharmacological interventions in this population to prevent secondary fractures may be warranted. SN - 1433-2965 UR - https://www.unboundmedicine.com/medline/citation/29063216/Older_men_who_sustain_a_hip_fracture_experience_greater_declines_in_bone_mineral_density_at_the_contralateral_hip_than_non_fractured_comparators_ L2 - https://doi.org/10.1007/s00198-017-4280-0 DB - PRIME DP - Unbound Medicine ER -