Skip to main content
 
Notice: Users may be experiencing issues with displaying some pages on stanfordhealthcare.org. We are working closely with our technical teams to resolve the issue as quickly as possible. Thank you for your patience.
Stanford Health Care

Characteristics Associated with 5-year Fracture Risk vs. 5-year Mortality Risk Among Late-life Men.

Characteristics Associated with 5-year Fracture Risk vs. 5-year Mortality Risk Among Late-life Men. The journals of gerontology. Series A, Biological sciences and medical sciences Langsetmo, L., Schousboe, J. T., Taylor, B. C., Cauley, J. A., Fink, H. A., Cawthon, P. M., Stefanick, M. L., Kado, D. M., Kats, A. M., Ensrud, K. E., Osteoporotic Fractures in Men (MrOS) Research Group 2022

Abstract

BACKGROUND: Identifying late-life men who might benefit from treatment to prevent fracture is challenging given high mortality. Our objective was to evaluate risks of clinical fracture, hip fracture, and mortality prior to fracture among men =80 years.METHODS: Study participants included 3,145 community-dwelling men (mean [SD] age 83 [2.8] years) from the Osteoporotic Fractures in Men (MrOS) Study. We used separate multivariable Fine-Gray competing risk models with pre-specified risk factors [age, hip bone mineral density (BMD), recent fracture (<5 years), fall history (previous year), and multimorbidity (# conditions)] to estimate sub-distribution hazard ratios and absolute 5-year risks of any clinical fracture and mortality prior to clinical fracture. Secondary analysis considered hip fracture.RESULTS: There were 414 incident clinical fractures and 595 deaths without prior fracture within 5 years. BMD, fall history, and recent fracture were strong predictors of clinical fracture. Age and multimorbidity were strong predictors of mortality before fracture. After accounting for competing risks, age, BMD, and fall history were each associated with both risk of hip fracture and mortality before hip fracture. Model discrimination varied from 0.65 (mortality before fracture) to 0.79 (hip fracture). Estimated mortality differed substantially among men with similar clinical fracture risk due to modest correlation between fracture risk and competing mortality risk=0.37.CONCLUSIONS: In late-life men, strong risk factors for clinical fracture and hip fracture include fall history, BMD, and recent fracture. Osteoporosis drug treatment decisions may be further enhanced by consideration of fracture risk versus overall life expectancy.

View details for DOI 10.1093/gerona/glac159

View details for PubMedID 35917212