Fractures due to osteoporosis in seniors a signal for premature death

Feb 3 2009

An Australian study has found that people over 60 years old who have had a fracture because of reduced bone density, or osteoporosis, face a higher risk of death over the next 5 to 10 years compared to the general population and those who experience additional fractures increase their risk of death further.

After age 60 osteoporosis becomes much more common, particularly for women who have gone through the menopause.

Osteoporosis increases the risk of fracture but it can however be prevented with lifestyle changes, including exercise, preventing falls, and drugs.

The Australian study was conducted by researchers at the Garvan Institute of Medical Research in Sydney and involved a total of 2,245 women and 1,760 men from Dubbo in New South Wales, who had suffered osteoporotic fractures between April 1989 and May 2007 - a tracking period of up to 18 years.

The researchers led by Dr. Dana Bliuc found that in women, there were 952 low-trauma fractures followed by 461 deaths, and in men, 343 fractures, followed by 197 deaths.

The premature deaths occurred across all age groups following hip, vertebral and major fractures for five years post-fracture except for minor fractures, where this was only apparent in the elderly (75 years+).

The researchers say though the mortality risk decreased after five years, with hip fractures the death risk remained elevated for up to 10 years.

Hip fractures can lead to decreased mobility and to complications such as deep vein thrombosis and blockages in arteries carrying blood from the heart to the lungs, but the researchers say non-hip, non-vertebral fractures accounted for almost 50% of the fractures and were also associated with 29% of the premature mortality.

In view of this the team suggest more attention should be given to non-hip, non-vertebral fractures and also caution against neglecting minor fractures as they say a subsequent fracture again resulted in an increased risk of death for a further five years.

The researchers say osteoporotic fractures represent a growing public health problem in both developed and developing countries, which will become more prevalent as people live longer all over the world.

There is a wealth of research which shows that weight bearing, aerobic exercise can maintain or increase bone mineral density, particularly in postmenopausal women and many experts also recommend quitting smoking and reducing alcohol consumption to prevent osteoporosis.

The researchers say the data suggests fracture is a signal event that heralds an increased risk of death which is associated with all types of fractures, particularly that which occurs after subsequent fracture across the whole age spectrum of older men and women.

The study is published in the Journal of American Medical Association.