Nguyen TV, Center JR, Sambrook PN, et al. Risk factors for proximal humerus, forearm, and wrist fractures in elderly men and women: the Dubbo Osteoporosis Epidemiology Study

Bone and Mineral Research Program, Garvan Institute of Medical Research, St. Vincent's Hospital, Sydney, Australia.
American Journal of Epidemiology (Impact Factor: 5.23). 03/2001; 153(6):587-95.
Source: PubMed


Fractures of the proximal humerus, forearm, and wrist account for approximately one third of total osteoporotic fractures in the elderly. Several risk factors for these fractures were evaluated in this prospective study of 739 men and 1,105 women aged > or =60 years in Dubbo, Australia. During follow-up (1989-1996), the respective incidences of humerus and of forearm and wrist fractures, per 10,000 person-years, were 22.6 and 33.8 for men and 54.8 and 124.6 for women. Independent predictors of humerus fracture were femoral neck bone mineral density (FNBMD) (relative risk (RR) = 2.3, 95% confidence interval (CI): 1.2, 4.5) in men and FNBMD (RR = 2.4, 95% CI: 1.7, 3.5) and height loss (RR = 1.1, 95% CI: 1.0, 1.2) in women. For forearm and wrist fractures, risk factors were FNBMD (men: RR = 1.5, 95% CI: 1.0, 2.3; women: RR = 1.5, 95% CI: 1.2, 1.9) and height loss (men: RR = 1.2, 95% CI: 1.0, 1.3; women: RR = 1.1, 95% CI: 1.0, 1.2). In addition, dietary calcium (men: RR = 2.0, 95% CI: 1.0, 3.6) and a history of falls (women: RR = 1.9, 95% CI: 1.4, 2.6) were also significant. These data suggest that elderly men and women largely share common risk factors for upper limb fractures and that FNBMD is the primary risk factor.

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Available from: Tuan V. Nguyen, Aug 04, 2015
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    • "In six studies a random sample of participants were included [4], [5], [11], [14], [26], [35], in 3 participants were included in a consecutive manner [12], [18], [32] and in 17 studies an arbitrary sample has been evaluated [7], [8], [9], [15], [16], [19], [20], [21], [22], [23], [24], [25], [27], [28], [31], [34], [38] and in 9 no information about inclusion has been reported [6], [10], [13], [15], [17], [29], [30], [33], [37]. Variables were defined clearly and clinically sensible in 34 studies [4], [5], [6], [7], [8], [9], [10], [11], [12], [14], [15], [16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [32], [33], [34], [35], [36], [37], [38]. In general the quality of the studies was moderate. "
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    ABSTRACT: There is a plethora of evidence available studying the association of risk profiles and the development of osteoporotic fractures. The small number of out-of-sample validations, the large variety of study characteristics, outcomes and follow-up periods impedes from deriving robust summaries and from conclusions regarding the clinical performance of many tools. First and foremost, future activity in this field should aim at reaching a consensus among clinical experts in respect to the existing instruments. Then we call for careful validations and expedient adaptations for local circumstances of the most promising candidates.
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    • "ver, postmenopausal osteoporosis also increased the risk of fractures [5] [6] , especially hip and spine fractures, which are associated with high morbidity and mortality in this population [7] [8] . Because bone fracture prevention is the primary aim of osteoporosis treatment, an assessment of bone strength is absolutely required to determine fracture risk in patient. "
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    Full-text · Article · Nov 2010
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    • "This study was built on the ongoing prospective Dubbo Osteoporosis Epidemiology Study (DOES), in which details of protocol and study design have been described previously.20212223Briefly, in 1989, all men and women aged 60 years or above (as of 1989) living in Dubbo, a city of approximately 32,000 people 400 km northwest of Sydney (Australia), were invited to participate in an epidemiologic study. At that time, the population consisted of 1581 men and 2095 women aged 60 years or older, of whom 98.6% were white and 1.4% were indigenous aboriginal . "
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    ABSTRACT: Osteoporosis and its consequence of fracture in men are increasingly recognized as a major men's health issue with public health significance. Among those aged 60 years or above, approximately one-third of all fractures in the general population occur in men. Men with an initial fracture are at increased risk of subsequent fracture. Although the risk of an initial fracture in men is lower than that in women, the absolute risk of subsequent fracture in men is comparable to that in women. It is well known that men with a fracture have a greater risk of premature mortality than women. For instance, the relative risk of one-year mortality in men with a hip fracture was 4.2, which was higher than that in women (relative risk 3.3) and it appears that most of the excess death occurs within 6 months after the fracture. These facts collectively suggest that fracture in men is a serious medical condition and novel thinking about prevention should be high on the agenda of research and development. One important component of fracture prevention is the development of effective prognostic models for identifying men at high-risk of fragility fracture. This chapter contends that the prognosis of fracture should be individualized by making use of multiple risk factors to which an individual is uniquely exposed.
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