Bone density at various sites for prediction of hip fractures
Abstract
Women with low bone density in the radius or calcaneus are at increased risk of hip fracture. To see whether bone density of the hip measured by dual X-ray absorptiometry is a better predictor of hip fracture than measurements of other bones, we assessed bone density at several sites in 8134 women aged 65 years or more. 65 women had hip fractures during a mean follow-up of 1.8 years. Each SD decrease in femoral neck bone density increased the age-adjusted risk of hip fracture 2.6 times (95% CL 1.9, 3.6). Women with bone density in the lowest quartile had an 8.5-fold greater risk of hip fracture than those in the highest quartile. Bone density of the femoral neck was a better predictor than measurements of the spine (p < 0.0001), radius (p < 0.002), and moderately better than the calcaneus (p = 0.10). Low hip bone density is a stronger predictor of hip fracture than bone density at other sites. Efforts to prevent hip fractures should focus on women with low hip bone density.
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Age-related bone loss is accompanied by a sharply higher risk of fractures.
“The declines in bone mass and density with age are accompanied by a drastically increased risk for fractures,168”
From Hormonal and Metabolic Changes of Aging and the Influence of Lifestyle Modifications (2021) · cites this paper as [168]
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- Authors
- Cummings, S. R., Browner, W., Cummings, S. R., Black, D. M., Nevitt, M. C., Browner, W., Genant, H. K., Cauley, J., Ensrud, K., Scott, J., & Vogt, T. M.
- Affiliations
- University of California, San Francisco (US)
- University of Pittsburgh (US)
- University of Minnesota (US)
- Kaiser Permanente Center for Health Research (US)
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 1993-01
- Volume
- 341
- Issue
- 8837
- Pages
- 72-75
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W1982942836
- Cited by
- 2,446
- References
- 27
- Citations by year
- 2026: 16 · 2025: 28 · 2024: 33 · 2023: 20 · 2022: 29 · 2021: 40 · 2020: 60 · 2019: 37 · 2018: 37 · 2017: 48 · 2016: 48 · 2015: 53 · 2014: 59 · 2013: 61 · 2012: 68
- FWCI
- 112.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (1-RO1-AG05407, R01AG005394, 5 RO1-AG05394, R01AG005407)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (1-RO1-AR35582, R01AR035582)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Surgery › Hip and Femur Fractures
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- hip fracture, bone mineral density, femoral neck, dual-energy X-ray absorptiometry, osteoporosis, fracture risk prediction, women, radius, calcaneus, spine, osteoporotic fracture prevention
- MeSH terms
- Aged, Aged, 80 and over, Calcaneus, Female, Femur, Hip Fractures, Humans, Lumbar Vertebrae, Predictive Value of Tests, Prospective Studies, Radius, ROC Curve, Absorptiometry, Photon, Bone Density, Proportional Hazards Models
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