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Age-Related Factors Associated With The Risk of Hip Fracture |
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| Institution: | 1. Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA;2. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA;3. Geriatric Research Education and Clinical Center, VA Health Care System, Minneapolis, MN;4. Department of Medicine, University of California, Irvine, CA;5. Department of Medicine, Beth Israel Deaconess Medical Center, Brookline, MA;6. Division of Endocrinology, Kaiser Permanente of Georgia, and Department of Endocrinology, Emory University School of Medicine, Atlanta, GA;1. Department of Endocrinology and Nutrition, Ramón y Cajal University Hospital, Madrid, Spain;2. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain;3. Department of Medicine, Universidad de Alcalá, Madrid, Spain;4. Department of Biochemistry, Ramón y Cajal University Hospital, Madrid, Spain;5. Department of Biochemistry and Molecular Genetics, Hospital Clinic, Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain;6. Department of Endocrinology and Nutrition. Hospital Clinic, IDIBAPS, Barcelona, Spain;7. Department of Diagnostic Imaging, Ramón y Cajal University Hospital, Madrid, Spain;8. Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain;1. Department of Pathology, Houston Methodist Hospital, Houston, Texas;2. Department of Pathology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio;3. Department of Pathology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois;4. Endocrinology and Metabolism Institute, Cleveland Clinic Foundation, Cleveland, Ohio;1. Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia;2. Department of Clinical Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia;3. Center for Health Outcomes & PharmacoEconomic Research, University of Arizona, Tucson, Arizona;4. Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia;5. Department of Pharmacy Practice, King Abdulaziz University Faculty of Pharmacy, Jeddah, Saudi Arabia;6. Banner—University Medicine Endocrinology and Diabetes Clinic, Tucson, Arizona;7. Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, College of Medicine, Tucson, Arizona;8. Department of Pharmacy Practice & Science, College of Pharmacy, The University of Arizona, Tucson, Arizona;1. The Department of General Surgery, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China;2. Department of Ultrasonography, Yuhang Third People’s Hospital, Hangzhou, China;3. Department of Ultrasonography, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China;1. Mayo Clinic Department of Medicine, Division of Endocrinology, Diabetes, Nutrition Rochester, Minnesota;2. Midwest Endocrinology, Crystal Lake, Illinois;3. Mayo Clinic Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Jacksonville, Florida |
| Abstract: | ObjectiveAdvancing age is a powerful risk factor for hip fractures. The biological mechanisms through which aging impacts the risk of hip fractures have not been well studied.MethodsBiological factors associated with “advancing age” that help to explain how aging is associated with the risk of hip fractures are reviewed. The findings are based on analyses of the Cardiovascular Health Study, an ongoing observational study of adults aged ≥65 years with 25 years of follow-up.ResultsThe following 5 age-related factors were found to be significantly associated with the risk of hip fractures: (1) microvascular disease of the kidneys (albuminuria and/or elevated urine-albumin-to-creatinine ratio) and brain (abnormal white matter disease on brain magnetic resonance imaging); (2) increased serum levels of carboxymethyl-lysine, an advanced glycation end product that reflects glycation and oxidative stress; (3) reduced parasympathetic tone, as derived from 24-hour Holter monitoring; (4) carotid artery atherosclerosis in the absence of clinical cardiovascular disease; and (5) increased transfatty acid levels in the blood. Each of these factors was associated with a 10% to 25% increased risk of fractures. These associations were independent of traditional risk factors for hip fractures.ConclusionSeveral factors associated with older age help to explain how “aging” may be associated with the risk of hip fractures. These same factors may also explain the high risk of mortality following hip fractures. |
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