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Residual lifetime risk of fractures in women and men

Nguyen, Nguyen D.; Ahlborg, Henrik LU ; Center, Jacqueline R.; Eisman, John A. and Nguyen, Tuan V. (2007) In Journal of Bone and Mineral Research 22(6). p.781-788
Abstract
In a sample of 1358 women and 858 men, >= 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 <=-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 >= 60 yr of... (More)
In a sample of 1358 women and 858 men, >= 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 <=-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 >= 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 <= -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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
aging, BMD, lifetime risk, residual, short-term risk, postmenopause, fracture, osteoporosis
in
Journal of Bone and Mineral Research
volume
22
issue
6
pages
781 - 788
publisher
AMBMR
external identifiers
  • wos:000246678300002
  • scopus:34548139467
ISSN
1523-4681
DOI
10.1359/jbmr.070315
language
English
LU publication?
yes
id
83c53802-11af-4e7d-8726-c924c18effdc (old id 659461)
date added to LUP
2007-12-18 13:00:07
date last changed
2017-11-12 03:21:09
@article{83c53802-11af-4e7d-8726-c924c18effdc,
  abstract     = {In a sample of 1358 women and 858 men, &gt;= 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 &lt;=-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 &gt;= 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 &lt;= -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.},
  author       = {Nguyen, Nguyen D. and Ahlborg, Henrik and Center, Jacqueline R. and Eisman, John A. and Nguyen, Tuan V.},
  issn         = {1523-4681},
  keyword      = {aging,BMD,lifetime risk,residual,short-term risk,postmenopause,fracture,osteoporosis},
  language     = {eng},
  number       = {6},
  pages        = {781--788},
  publisher    = {AMBMR},
  series       = {Journal of Bone and Mineral Research},
  title        = {Residual lifetime risk of fractures in women and men},
  url          = {http://dx.doi.org/10.1359/jbmr.070315},
  volume       = {22},
  year         = {2007},
}