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Risk factors for fracture in elderly men: a population-based prospective study

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Abstract

Summary

Risk factors for fractures were assessed in a random sample of 4,696 elderly men followed for 5.4 years. Results highlighted the importance of assessment of falls and dizziness as well as novel risk factors including frequent urination and erectile dysfunction.

Introduction

Knowledge about risk factors for fracture in men is limited. The aim of this study was to evaluate factors potentially associated with fracture risk in men.

Methods

A questionnaire enquiring about potential risk factors for fractures in men was posted to a random sample of 9,314 men aged 60–74 years. A completed questionnaire was returned by 4,696 (50.4%). Follow-up on incident fractures over 5.4 years was performed using public registries.

Results

During the study, 203 individuals experienced a first clinical fracture, of which 85 patients were considered osteoporotic (9 in humerus, 10 vertebral, 32 in the hip and 34 in the forearm). Cox proportional hazard regression models were used to evaluate risk factors for any and osteoporotic fractures. The following variables were found to be associated with increased risk of any fracture in adjusted models family history of a hip fracture (HR; 95%CI: 1.56; 1.05–2.33), falls (2–4/year: 2.10; 1.35–3.27, >4/year: 2.46; 1.12–5.41, both compared to no falls), dizziness (2.36; 1.51–3.71), erectile dysfunction (1.41; 1.06–1.87) and frequent urination (2.06; 1.26–3.39). Similarly, falls (2.36; 1.45–3.86), dizziness (2.83; 1.52–5.25), erectile dysfunction (2.01; 1.30–3.09) and pulmonary illness (1.90; 1.03–3.53) were associated with increased risk of osteoporotic fractures in adjusted models.

Conclusion

These results underline the importance of assessment of dizziness, falls and those with a family history of hip fracture. Frequent urination and erectile dysfunction were independently associated with increased fracture risk. Although the mechanism of association is unknown, these variables are likely to be indicators of frailty or hypogonadism.

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Acknowledgements

The study received financial support from the Institute of Clinical Research, University of Southern Denmark, the Novo Nordisk Foundation and the Velux Foundation.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Endocrinology, Odense University Hospital, DK-5000, Odense, Denmark

    M. Frost & K. Brixen

  2. Clinical Research Institute, University of Southern Denmark, Odense, Denmark

    M. Frost, B. Abrahamsen, T. Masud & K. Brixen

  3. Department of Medicine F, Copenhagen University Hospital Gentofte, Hellerup, Denmark

    B. Abrahamsen

  4. Department of Geriatrics, Nottingham City Hospital, Nottingham, UK

    T. Masud

  5. Department of Geriatrics, Odense University Hospital, Odense, Denmark

    T. Masud

Authors
  1. M. Frost
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  2. B. Abrahamsen
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  3. T. Masud
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  4. K. Brixen
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Corresponding author

Correspondence to M. Frost.

Appendix A

Appendix A

Table 6 Variables used for calculation of the Charlson index. Information obtained from public register
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Appendix B

Table 7 Items in questionnaire
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Frost, M., Abrahamsen, B., Masud, T. et al. Risk factors for fracture in elderly men: a population-based prospective study. Osteoporos Int 23, 521–531 (2012). https://doi.org/10.1007/s00198-011-1575-4

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  • DOI: https://doi.org/10.1007/s00198-011-1575-4

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