Broken bones may lift death risk for seniors

If you’re over 60 and suffer a broken bone, it can increase your risk of death over the next five to ten years, according to an Australian study published in the Journal of the American Medical Association (JAMA).

Osteoporotic fractures represent a growing public health problem in both developed and developing countries, and the situation is projected to worsen as the population ages.

There is limited data on the long-term risk of death following osteoporotic fracture or a subsequent fracture, according to background information in the article.

Dana Bliuc, M.Med., of the Garvan Institute of Medical Research at St. Vincent’s Hospital in Sydney, and colleagues examined the long-term risk of death following all types of osteoporotic fractures in women and men in different age groups and the association of subsequent fracture with the risk of death.

The study included women and men age 60 years and older from Dubbo, who sustained a fracture between April 1989 and May 2007.

In women, there were 952 low-trauma fractures followed by 461 deaths, and in men, 343 fractures were followed by 197 deaths.

In comparison to the general population, increased mortality risk was observed across all age groups following hip, vertebral, and major fractures for five years post-fracture except for minor fractures, where an increased risk of death was only apparent in those aged 75 years or older.

After five years, the mortality risk decreased, but with hip fractures the associated mortality risk remained elevated for up to ten years.

After ten years, mortality rates were not different from that of an appropriately age-matched population.

“Non-hip, non-vertebral fractures, generally not considered in these types of studies, not only constituted almost 50% of the fractures studied, but also were associated with 29% of the premature mortality.

Mortality risk decreased with time; however, the occurrence of a subsequent fracture was associated with a three to four-fold increased mortality risk for a further five years,” the authors write.

“Given these findings, more attention should be given to non-hip, non-vertebral fractures.

“Predictors of death after any fracture for both men and women included age, quadriceps weakness and subsequent fracture but not co-existing illnesses. Low bone mineral density and having smoked were also predictors for women as was less physical activity for men.

“These data suggest fracture is a signal event that heralds an increased mortality risk: whether it is related to an underlying increased risk for both fracture and mortality, which may be the case for women, or whether it is related to some aspect of the fracture event itself, as appears to be the case for men, needs further exploration.

Overall, this study highlights the premature mortality associated with all types of fractures, particularly that which occurs after subsequent fracture across the whole age spectrum of older men and women,” the researchers concluded.