Fractures in Older Adults Up Death Risk

TUESDAY Feb. 3, 2009 -- Any bone fracture that occurs in people over age 60 needs to be taken seriously, a new study concludes.

That's because the Australian researchers found the risk of dying goes up for at least five years following any low-trauma fracture, and for at least 10 years after a hip fracture.

"All low-trauma fractures are associated with premature mortality, not just hip fractures," said study senior author Dr. Jacqueline Center, an associate professor and senior research officer at the Garvan Institute of Medical Research, in Sydney.

"Thus, all low-trauma fractures in the elderly need to be regarded as important events," she noted, adding, "Anti-osteoporosis treatment -- assuming a low bone density -- should be instituted following any low-trauma fracture to at least decrease the risk of a subsequent fracture, although we have yet to see whether it will decrease mortality."

Results of the study were published in the Feb. 4 issue of the Journal of the American Medical Association.

Each year, more than one-third of Americans aged 65 and older will experience a fall, and nearly 16,000 of those people will die as a result of those falls, according to the U.S. Centers for Disease Control and Prevention.

Statistics for the new research came from a large study of 32,000 people living in Dubbo, Australia. Slightly more than 4,000 of the people were over age 60 at the start of the study, and were community-dwelling, which means they weren't in a hospital or residential care facility.

Between 1989 and 2007, 952 women and 343 men experienced low-trauma fractures. Some time after their fracture, 461 of the women and 197 of the men died.

The researchers found the risk of death increased more than twofold for women and more than threefold for men following a hip fracture. The risk of death after other major fractures increased by 65 percent for women and 70 percent for men. Even after minor fractures, such as a wrist fracture, the mortality risk increased by 42 percent in women and 33 percent in men, although this increase was only statistically significant for those over 75.

The increased risk of death persisted for five years for all fractures and up to 10 years after a hip fracture, the study found.

Increased age and a second fracture also increased the risk of death, as did lesser strength in the quadriceps -- the large thigh muscle.

Dr. David Markel, chief of orthopedics at Providence Hospital in Southfield, Mich., said he believes most fractures indicate other underlying problems.

"As people age, having a fall or other things that lead to fracture should be looked at as a cue that there are other health issues. It's important to not minimize osteoporotic fractures overall, and we should use these events as an indicator for health intervention and prevention," he said.

This study also confirms what a lot of other research says, Markel noted: "Continued physical activity and a healthy lifestyle is good for you as you age."

More information

Learn more about who's at risk for falls and learn ways to prevent falls and fractures from the U.S. Centers for Disease Control and Prevention.

Posted: February 2009


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