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 Illiteracy and depression increase the risks of fracture for senior
women, while smoking and disability raise the risk for senior men.
Dementia doesn’t increase the risk of hip fractures, but being
married or having a partner does reduce the risk for men and women,
say the authors.
Each year, more than 300,000 Americans over the age of 65 are
hospitalized for hip fractures, according to the Centers for Disease
Control and Prevention. About three out of four hip fractures occur
in women.
The study, published in Maturitas, was led by Elena Lobo of the
Department of Preventive Medicine and Public Health at Zaragoza
University in Spain.
Lobo and colleagues analyzed medical and psychiatric histories for
4,803 adults in Zaragoza over the age of 55, including the number of
hip fractures.
Participants were 73 years old, on average. Over the course of 16
years, about 8 percent of women broke a hip, compared to less than 3
percent of men.
Among the women in the study, being unable to read increased the
risk of hip fracture by about 50 percent and being diagnosed with
depression increased the risk by 44 percent.
For the men, smoking doubled the risk of hip fracture and being
disabled tripled the risk.
“It is well documented that smoking is harmful to bone health,” Dr.
Heike Bischoff-Ferrari told Reuters Health in an email.
“Additionally, most important at older age – smoking reduces calorie
intake,” she added. The U.S. National Institutes of Health warns
that being underweight is a risk factor for poor bone health.
Bischoff-Ferrari, who chairs the Geriatrics and Aging Research
Department at University Hospital Zurich, Switzerland, said
disability as a risk factor makes a lot of sense.
“Disability increases the risk of falling and falling is the primary
risk factor for hip fractures,” said Bischoff-Ferrari, who wasn’t
involved in the new study. “Disability also has a direct effect on
bone and muscle health as disability reduces mobility – and thereby
loss of both bone and muscle mass is the consequence – enhancing the
risk of falls and hip fractures.”
Men who were coupled were half as likely to suffer a hip fracture
and women who were married or lived with someone were 30 percent
less likely to break a hip.
Bischoff-Ferrari said this finding also makes sense because seniors
who live with a partner are less likely to be malnourished or
depressed and more likely to have support with a possible
disability.
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"All of those risk factors have been associated with an increased
risk of falling and sustaining a hip fracture," she said.
Bischoff-Ferrari said it's not clear why the study did not capture
dementia as a risk factor when previous findings have shown that
cognitive impairment is increasing the risk of falls and fractures.
"One explanation may be the correlation of risk factors – for
example, we know that physical and cognitive impairment are closely
correlated. The authors had both risk factors in their model, which
may have led to the missing signal for dementia," she said.
She has some advice for reducing the risk of hip fractures.
“It is well documented that clearing the apartment of seniors from
fall hazards, such as loose carpets, is effective, as is better
lighting and hand grips to hold on to in the bathroom,”
Bischoff-Ferrari said.
Bischoff-Ferrari said it’s also important to make sure that older
adults are consuming an adequate number of calories. Their diet
should focus on calcium and protein rich foods to prevention bone
and muscle mass loss.
Bischoff-Ferrari added that exercise - for example, walking 30
minutes each day - has been shown to reduce the risk of hip
fracture.
“Last but not least, a vitamin D supplement of 800 International
Units per day has been shown to correct vitamin D deficiency and
reduce falls and hip fractures by up to 30 percent,” she said.
The authors of the study did not respond to a request for comment.
SOURCE: http://bit.ly/2j5c9l1 Maturitas, online December 28, 2016.
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