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Hearing loss but not bone-regulating hormones predicts fractures in older women—a 17-year follow-up of the Gothenburg BEDA study

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Abstract

Summary

High-frequency hearing loss and S-Ca, but not hormones related to bone structure and strength, or lifestyle factors, predicted incident fractures during 17 years of follow-up in women up to 97 years of age.

Introduction

The fracture risk increases and inner ear function deteriorates with increasing age. The aim of this study was to investigate whether hearing loss was of greater importance than bone-regulating hormones for the risk of fracture in elderly women.

Methods

In 1997, a random population sample of 63–82-year-old women, n = 552, underwent a physical examination, audiometry and blood sampling for analyses of serum albumin-adjusted calcium (S-Ca), parathyroid hormone (PTH), 25(OH) vitamin D and insulin-like growth factor-1 (IGF-1). Data on medication, lifestyle, previous fractures, hearing, vision and dizziness were obtained using questionnaires. Data on subsequent fractures were retrieved, and censored at death, through December 2013.

Results

In 1997, 228 women (41%) reported a previous fracture, most commonly of the wrist (18%). During the following 17 years, 323 fractures occurred in 207 women (38%). Hip fractures were the most frequent, in 96 women (17%). In a Cox regression analysis adjusted for age and previous fractures, hearing loss, reflected by a high pure tone average ≥ 59 dB, almost doubled the risk of a subsequent fracture (hazard ratio (HR) 1.81, 95% CI 1.25; 2.61, p = 0.002). S-Ca (HR 1.21 (1.02; 1.44) p = 0.028) also predicted future fractures, whereas PTH, IGF-1, 25(OH) vitamin D, hormone replacement therapy, smoking, degree of physical activity, impaired vision and dizziness did not.

Conclusion

Hearing loss and higher S-Ca, but not bone-regulating hormones, medication or lifestyle factors predicted incident fractures, mainly caused by falling, during 17 years of follow-up in women up to 97 years of age.

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Acknowledgements

The excellent help with statistical analyses by Mattias Molin and Henrik Albrektsson and the help from the department of Audiology are gratefully acknowledged.

Funding

The study was financed by grants from the Swedish state under the agreement between the Swedish government and the county councils, the ALF agreement (ALFGBG-718611).

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Authors and Affiliations

  1. Department of Medicine, Sahlgrenska University Hospital/Östra, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    A. Dotevall & K. Landin-Wilhelmsen

  2. Department of Physiology at the Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    M.-L. Barrenäs

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  1. A. Dotevall
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  2. M.-L. Barrenäs
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  3. K. Landin-Wilhelmsen
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Correspondence to A. Dotevall.

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Dotevall, A., Barrenäs, ML. & Landin-Wilhelmsen, K. Hearing loss but not bone-regulating hormones predicts fractures in older women—a 17-year follow-up of the Gothenburg BEDA study. Osteoporos Int 31, 557–565 (2020). https://doi.org/10.1007/s00198-019-05204-2

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