Osteoporosis International

, Volume 19, Issue 5, pp 615–623

Rate and circumstances of clinical vertebral fractures in older men

  • S. S. Freitas
  • E. Barrett-Connor
  • K. E. Ensrud
  • H. A. Fink
  • D. C. Bauer
  • P. M. Cawthon
  • L. C. Lambert
  • E. S. Orwoll
  • for the Osteoporotic Fractures in Men (MrOS) Research Group
Original Article

DOI: 10.1007/s00198-007-0510-1

Cite this article as:
Freitas, S.S., Barrett-Connor, E., Ensrud, K.E. et al. Osteoporos Int (2008) 19: 615. doi:10.1007/s00198-007-0510-1

Abstract

Summary

We examined the rate of clinical vertebral fractures, and the circumstances associated with the fractures, in a cohort of 5,995 US older men. Fractures were more common in the most elderly men, and were usually associated with falls and other low-energy trauma.

Introduction

Little is known about clinical vertebral fractures in older men. We postulated that clinical vertebral fractures occur with falls, affect men with osteoporosis, and are more common as age increases.

Methods

Five thousand nine hundred and ninety-five men aged ≥65 years were followed prospectively for an average of 4.7 years. Men with incident clinical vertebral fractures were compared to controls.

Results

One percent (n = 61) sustained incident clinical vertebral fractures (2.2/1,000 person-years). The rate of fracture rose with age (0.7% in men 65–69 years and 5% ≥85 years). Fractured men were more likely frail (8.2% vs. 2.2%), more often fell (36.1% vs. 21%) and had lower total hip and lumbar spine BMD (all p values ≤0.002). In 73.8% of cases fractures were precipitated by no known trauma or by low-energy trauma, including falls in 57.3% Fractures were thoracic in 33% and lumbar in 56%. Men with an incident vertebral fracture were more likely to be osteoporotic (13% vs. 2%, p < 0.0001), but most men with incident fractures did not have osteoporosis.

Conclusions

Incident clinical vertebral fractures were relatively common in older men and the rate increased after age 80 years. Fractures were usually associated with minimal trauma, most commonly a fall.

Keywords

BMD Epidemiology Men Osteoporosis Vertebral fractures 

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2007

Authors and Affiliations

  • S. S. Freitas
    • 1
    • 2
  • E. Barrett-Connor
    • 3
  • K. E. Ensrud
    • 4
  • H. A. Fink
    • 4
  • D. C. Bauer
    • 5
  • P. M. Cawthon
    • 6
  • L. C. Lambert
    • 1
  • E. S. Orwoll
    • 1
  • for the Osteoporotic Fractures in Men (MrOS) Research Group
  1. 1.Bone and Mineral Unit, Department of MedicineOregon Health and Science UniversityPortlandUSA
  2. 2.Department of MedicineFederal University of ParanaCuritibaBrazil
  3. 3.Department of Family and Preventive MedicineUniversity of CaliforniaSan DiegoUSA
  4. 4.Department of MedicineVeterans Affairs Medical CenterMinneapolisUSA
  5. 5.Department of MedicineUniversity of CaliforniaSan FranciscoUSA
  6. 6.Research InstituteCalifornia Pacific Medical CenterSan FranciscoUSA