Height loss in older women: Risk of hip fracture and mortality independent of vertebral fractures

Teresa A. Hillier, Li Yung Lui, Deborah M. Kado, Es Leblanc, Kimberly K. Vesco, Douglas C. Bauer, Jane A. Cauley, Kristine E. Ensrud, Dennis M. Black, Marc C. Hochberg, Steven R. Cummings

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

We examined if height loss in older women predicts risk of hip fractures, other nonspine fractures, and mortality, and whether this risk is independent of both vertebral fractures (VFx) and bone mineral density (BMD) by dual-energy X-ray absorptiometry. Among 3124 women age 65 and older in the Study of Osteoporotic Fractures, we assessed the association with measured height change between year 0 (1986-1988) and year 15 (2002-2004) and subsequent risk of radiologically confirmed hip fractures, other nonspine fractures, and mortality assessed via death certificates. Follow-up occurred every 4 months for fractures and vital status (>95% contacts complete). Cox proportional hazards models assessed risk of hip fracture, nonspine fracture, and mortality over a mean of 5 years after height change was assessed (ie, after final height measurement). After adjustment for VFx, BMD, and other potential covariates, height loss >5 cm was associated with a marked increased risk of hip fracture [hazard ratio (HR) 1.50, 95% confidence interval (CI) 1.06, 2.12], nonspine fracture (HR 1.48; 95% CI 1.20, 1.83), and mortality (1.45; 95% CI 1.21, 1.73). Although primary analyses were a subset of 3124 survivors healthy enough to return for a year 15 height measurement, a sensitivity analysis in the entire cohort (n=9677) using initial height in earlier adulthood [self-reported height at age 25 (-40 years) to measured height age >65 years (Year 0)] demonstrated consistent results. Height loss >5 cm (2″) in older women was associated with a nearly 50% increased risk of hip fracture, nonspine fracture, and mortality-independent of incident VFx and BMD.

Original languageEnglish (US)
Pages (from-to)153-159
Number of pages7
JournalJournal of Bone and Mineral Research
Volume27
Issue number1
DOIs
StatePublished - Jan 2012

Keywords

  • AGING
  • EPIDEMIOLOGY
  • OSTEOPOROSIS
  • POPULATION STUDIES

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