Osteoporosis International

, Volume 13, Issue 8, pp 606–612

Quantitative Ultrasound and Mortality: A Prospective Study


  • D. C. Bauer
    • Division of General Internal Medicine
  • D. C. Bauer
    • Department of Epidemiology and Biostatistics, University of California, San Francisco;
  • L. Palermo
    • Department of Epidemiology and Biostatistics, University of California, San Francisco;
  • D. Black
    • Department of Epidemiology and Biostatistics, University of California, San Francisco;
  • J. A. Cauley for the Study of Osteoporotic Fractures Research Group: Universities of California (San Francisco), Pittsburgh, Minnesota (Minneapolis),Kaiser Center for Health Research, Portland
    • Department of Epidemiology, University of Pittsburgh, USA
Original Article

DOI: 10.1007/s001980200081

Cite this article as:
Bauer, D., Bauer, D., Palermo, L. et al. Osteoporos Int (2002) 13: 606. doi:10.1007/s001980200081


Previous studies suggest that low bone mineral density (BMD) is associated with increased mortality, but the relationship between quantitative ultrasound (QUS) and mortality is unknown. We studied 5816 women over age 70 years enrolled in the Study of Osteoporotic Fractures. QUS of the calcaneus, and BMD of the calcaneus and hip, were measured at baseline, and women were contacted every 4 months to determine vital status. All reported deaths were confirmed by review of the death certificate or hospital records, and classified by ICD-9 code. During 5.0 years of follow-up, 677 women died. Women in the lowest quintile of QUS had the highest mortality during follow-up. After adjustment for age, grip strength, weight, height, health status, estrogen use, smoking, physical activity, and history of hypertension, diabetes, cardiovascular disease, cancer and stroke, each 1 SD reduction in broadband ultrasonic attenuation (BUA) was associated with a 16% increase in mortality (RH = 1.16; 95% CI: 1.07, 1.26). Mortality from cardiovascular disease, cancer and other causes were all increased among women with low QUS, but the association with cancer deaths was not statistically significant after multiple adjustments (RH = 1.09; CI: 0.93, 1.27). Low BMD was also associated with an increased risk of total and cause-specific mortality, but we found little evidence that BUA and BMD were independent predictors of mortality. Results were similar among women who did not fracture during follow-up. In this large population-based study of older women, low QUS is associated with both total and cause-specific mortality. This relationship was independent of other factors associated with mortality, such as age and health status, and suggests QUS and BMD may reflect some aspect of aging not captured by these traditional factors.

Key words:Bone mineral density – Mortality – Prospective cohort – Quantitative ultrasound

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2002