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Characteristics of incidence hip fracture cases in older adults participating in the longitudinal AGES-Reykjavik study

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A Correction to this article was published on 21 October 2020

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Abstract

Summary

Poor physical function and body composition my partly predict the risk of falls leading to fracture regardless of bone mineral density.

Introduction

To examine the relationship between body composition, physical function, and other markers of health with hip fractures in older community-dwelling Icelandic adults.

Methods

A prospective cohort of 4782 older adults from the AGES-Reykjavik study. Baseline recruitment took place between 2002 and 2006, and information on hip fractures occurring through 2012 was extracted from clinical records. Using multivariate regression analyses, baseline measures of bone health, physical function, and body composition were compared between those who later experienced hip fractures and to those who did not. Associations with the risk of fractures were quantified using Cox regression.

Results

Mean age was 76.3 years at baseline. After adjustment for age, regression showed that male hip fracture cases compared with non-cases had (mean (95% confidence interval)) significantly lower thigh muscle cross-sectional area − 5.6 cm2 (− 10.2, − 1.1), poorer leg strength – 28 N (− 49, − 7), and decreased physical function as measured by longer timed up and go test 1.1 s (0.5, 1.7). After adjustment for age, female cases had, compared with non-cases, lower body mass index − 1.5 kg/m2 (− 2.1, − 0.9), less lean mass − 1.6 kg (− 2.5, − 0.8), thigh muscle cross-sectional area − 4.4 cm2 (− 6.5, − 2.3), and worse leg strength − 16 N (− 25, − 6). These differences largely persisted after further adjustment for bone mineral density (BMD), suggesting that body composition may contribute to the risk of fracture independent of bone health. When examining the association between these same factors and hip fractures using Cox regression, the same conclusions were reached.

Conclusions

After accounting for age and BMD, older adults who later experienced a hip fracture had poorer baseline measures of physical function and/or body composition, which may at least partly contribute to the risk of falls leading to fracture.

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Change history

  • 21 October 2020

    The original version of this article, published on 18 august 2020 contained a mistake. An author’s name was misspelled.

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Funding

The original work was funded by the National Institutes of Health, USA, contract N01-AG-12100, and the National Institute on Aging Intramural Research Program, the National Eye Institute, USA (ZIAEY000401), Hjartavernd (The Icelandic Heart Association), and Althingi (Icelandic Parliament). Work on this study was in part funded by The St. Josef’s Hospital Fund, Reykjavik, Iceland, the Landspitali University Hospital Research Fund, the Icelandic Gerontological Society Research Fund, and the Helga Jonsdottir and Sigurlidi Kristjánsson Geriatric Research Fund.

Author information

Authors and Affiliations

  1. The Icelandic Gerontological Research Institute, Tungata 5, 101, Reykjavik, Iceland

    S. S. Skuladottir & A. Ramel

  2. Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland

    S. S. Skuladottir, A. Ramel, L. Steingrimsdottir & T. Halldorsson

  3. Landspitali National University Hospital of Iceland, Reykjavik, Iceland

    S. S. Skuladottir, I. Hjaltadottir, V. Gudnason & G. Sigurdsson

  4. Faculty of Nursing, University of Iceland, Reykjavik, Iceland

    I. Hjaltadottir

  5. Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, MA, USA

    L. J. Launer

  6. Division of Epidemiology and Clinical Applications, Intramural Research Program, National Eye Institute, National Institutes of Health, Bethesda, MA, USA

    MF. Cotch

  7. Icelandic Heart Association Research Institute, Kopavogur, Iceland

    K. Siggeirsdottir, V. Gudnason & G. Sigurdsson

Authors
  1. S. S. Skuladottir
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  2. A. Ramel
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  3. I. Hjaltadottir
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  4. L. J. Launer
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  5. MF. Cotch
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  6. K. Siggeirsdottir
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  7. V. Gudnason
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  8. G. Sigurdsson
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  9. L. Steingrimsdottir
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  10. T. Halldorsson
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Corresponding author

Correspondence to S. S. Skuladottir.

Ethics declarations

All participants provided written informed consent. The study was approved by the Icelandic National Bioethics Committee (VSN: 00-063) and the National Institute on Aging Intramural Institutional Review Board (MedStar IRB for the Intramural Research Program, Baltimore, MD).

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The original version of this article was revised: An author’s name was misspelled

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Skuladottir, S.S., Ramel, A., Hjaltadottir, I. et al. Characteristics of incidence hip fracture cases in older adults participating in the longitudinal AGES-Reykjavik study. Osteoporos Int 32, 243–250 (2021). https://doi.org/10.1007/s00198-020-05567-x

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  • DOI: https://doi.org/10.1007/s00198-020-05567-x

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