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Cited by 456Bone health and osteoporosis researchHip and Femur FracturesFrailty in Older Adults

Epidemiology of fracture risk with advancing age

Open access
Ensrud, K. E.·2013·The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
DOI 10.1093/gerona/glt092
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Abstract

Bone loss and structural damage with advancing age lead to skeletal fragility as manifested by low bone mass and deficits in bone geometry, microarchitecture, and material properties. Skeletal fragility, in combination with a greater propensity to fall, results in an increased susceptibility to fractures with aging, known as fragility fractures. Fragility fractures exceed 2 million per year in number and account for nearly 20 billion dollars per year in health care costs in the United States. Advanced age, low bone mass, and previous fracture are strong risk factors for fractures at nearly all skeletal sites, but each type of fracture also has its own set of unique risk factors. Hip fractures are most strongly associated with adverse consequences, but these account for only a minority of fragility fractures. Vertebral fractures comprise the most common manifestation of fragility fracture, but the majority of these fractures are asymptomatic. Most research has focused on the epidemiology of fractures at the hip, vertebrae, and wrist and less is known about other fracture types, which account for 40% of total fragility fractures that are clinically recognized. Future research focused on identification of older adults at high risk of disabling fractures is warranted.

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  • Typical aging symptoms commonly experienced before age 65 include loss of muscle mass and strength, weakening and embrittlement of bones (osteoporosis), loss of arterial elasticity and other cardiovascular changes, presbyopia, presbycusis, cardiovascular diseases, and menopause.

    “Some of the typical aging symptoms that could be commonly experienced before age 65 years (general retirement age in many countries) are as follows: - Loss of muscle mass and strength (21)- Weakening and embrittlement of bones (osteoporosis) (22)- Loss of arterial elasticity (atherosclerosis) and other cardiovascular changes (23)- Difficulty in focusing eyes on close objects (presbyopia)- Lowering”

    From Broadening the selection criteria for Astronauts undertaking long-term space travel (2022) · cites this paper as [22]

    Citation (22) is attached to the osteoporosis item, not the other symptoms in the list. The Summary says bone loss and structural damage with advancing age lead to skeletal fragility, and the Fragility Fractures section discusses osteoporosis and increasing bone loss in older adults. It does not establish that osteoporosis is commonly experienced before age 65; its age-specific example begins at 65–69. (LLM, conf=0.86)

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  • Besides hip fractures, vertebral fractures are the most common and most consequential osteoporotic fractures.

    “Besides hip fractures, vertebral fractures are the most common and most consequential osteoporotic fractures [4].”

    From Automatic opportunistic osteoporosis screening in routine CT: improved prediction of patients with prevalent vertebral fractures compared to DXA (2021) · cites this paper as [4]

    The Vertebral Fractures section calls vertebral fractures the most common manifestation of osteoporosis and describes associations with pain, disability, mortality, and subsequent fractures. It does not establish that they are the most consequential after hip fractures; it reports that clinical vertebral fractures accounted for only 6% of fracture-related costs in the United States in 2005. (LLM, conf=0.84)

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Research works printed but not linked: 2

  1. Silverman SL, Minshall ME, Shen W, Harper KD, Xie S; Health- Related Quality of Life Subgroup of the Multiple Outcomes of Raloxifene Evaluation Study. The relationship of health-related qual- ity of life to prevalent and incident vertebral fractures in postmenopau- sal women with osteoporosis: results from the Multiple Outcomes of Raloxifene Evaluation Study. Arthritis Rheum. 2001;44:2611-2619.
  2. Kelsey JL, Browner WS, Seeley DG, Nevitt MC, Cummings SR. Risk factors for fractures of the distal forearm and proximal humerus. The Study of Osteoporotic Fractures Research Group. Am J Epidemiol. 1992;135:477-489.

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Authors
Ensrud, K. E.
Affiliations
University of Minnesota (US)
Corresponding author
Ensrud, K. E.
ORCID
Ensrud, K. E.
Venue
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
Publisher
Oxford University Press (OUP)
Published
2013-07-05
Volume
68
Issue
10
Pages
1236-1242
ISSN
  • 1079-5006 (ISSN-L)
  • 1758-535X
DOI
10.1093/gerona/glt092
OpenAlex
W2112964941
Cited by
456
References
88
Citations by year
2026: 27 · 2025: 33 · 2024: 47 · 2023: 42 · 2022: 38 · 2021: 59 · 2020: 43 · 2019: 38 · 2018: 49 · 2017: 19 · 2016: 24 · 2015: 21 · 2014: 13 · 2013: 3
FWCI
3.36
Type
journal article
Language
en
Open access
Licence
public-domain
Locations
  • The Journals of Gerontology Series A (publishedVersion, public-domain)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
  • Health Sciences › Medicine › Surgery › Hip and Femur Fractures
  • Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
Keywords
fragility fractures, fracture risk, aging, osteopenia, bone loss, hip fracture, vertebral fractures, wrist fractures, falls, fracture risk factors, older adults, bone fragility
MeSH terms
Age Factors, Aged, Female, Humans, Male, Risk Factors, United States, Bone Density, Incidence, Health Care Costs, Fractures, Bone

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