Skip to main content
Erschienen in: Osteoporosis International 5/2008

01.05.2008 | Original Article

Rate and circumstances of clinical vertebral fractures in older men

verfasst von: S. S. Freitas, E. Barrett-Connor, K. E. Ensrud, H. A. Fink, D. C. Bauer, P. M. Cawthon, L. C. Lambert, E. S. Orwoll, for the Osteoporotic Fractures in Men (MrOS) Research Group

Erschienen in: Osteoporosis International | Ausgabe 5/2008

Einloggen, um Zugang zu erhalten

Abstract

Summary

We examined the rate of clinical vertebral fractures, and the circumstances associated with the fractures, in a cohort of 5,995 US older men. Fractures were more common in the most elderly men, and were usually associated with falls and other low-energy trauma.

Introduction

Little is known about clinical vertebral fractures in older men. We postulated that clinical vertebral fractures occur with falls, affect men with osteoporosis, and are more common as age increases.

Methods

Five thousand nine hundred and ninety-five men aged ≥65 years were followed prospectively for an average of 4.7 years. Men with incident clinical vertebral fractures were compared to controls.

Results

One percent (n = 61) sustained incident clinical vertebral fractures (2.2/1,000 person-years). The rate of fracture rose with age (0.7% in men 65–69 years and 5% ≥85 years). Fractured men were more likely frail (8.2% vs. 2.2%), more often fell (36.1% vs. 21%) and had lower total hip and lumbar spine BMD (all p values ≤0.002). In 73.8% of cases fractures were precipitated by no known trauma or by low-energy trauma, including falls in 57.3% Fractures were thoracic in 33% and lumbar in 56%. Men with an incident vertebral fracture were more likely to be osteoporotic (13% vs. 2%, p < 0.0001), but most men with incident fractures did not have osteoporosis.

Conclusions

Incident clinical vertebral fractures were relatively common in older men and the rate increased after age 80 years. Fractures were usually associated with minimal trauma, most commonly a fall.
Literatur
1.
Zurück zum Zitat O’Neill TW, Felsenberg D, Varlow J et al (1996) The prevalence of vertebral deformity in European men and women: the European Vertebral Osteoporosis Study. J Bone Miner Res 11:1010–1018PubMed O’Neill TW, Felsenberg D, Varlow J et al (1996) The prevalence of vertebral deformity in European men and women: the European Vertebral Osteoporosis Study. J Bone Miner Res 11:1010–1018PubMed
2.
Zurück zum Zitat Ettinger B, Black DM, Nevitt MC et al (1992) Contribution of vertebral deformities to chronic back pain and disability. The Study of Osteoporotic Fractures Research Group. J Bone Min Res 7:449–456 Ettinger B, Black DM, Nevitt MC et al (1992) Contribution of vertebral deformities to chronic back pain and disability. The Study of Osteoporotic Fractures Research Group. J Bone Min Res 7:449–456
3.
Zurück zum Zitat Nevitt MC, Ettinger B, Black DM et al (1998) The association of radiographically detected vertebral fractures with back pain and function: a prospective study. Ann Intern Med 128:793–800PubMed Nevitt MC, Ettinger B, Black DM et al (1998) The association of radiographically detected vertebral fractures with back pain and function: a prospective study. Ann Intern Med 128:793–800PubMed
4.
Zurück zum Zitat Hasserius R, Karlsson MK, Nilsson BE et al (2003) Prevalent vertebral deformities predict increased mortality and increased fracture rate in both men and women: a 10-year population-based study of 598 individuals from the Swedish cohort in the European Vertebral Osteoporosis Study. Osteoporos Int 14:61–68PubMedCrossRef Hasserius R, Karlsson MK, Nilsson BE et al (2003) Prevalent vertebral deformities predict increased mortality and increased fracture rate in both men and women: a 10-year population-based study of 598 individuals from the Swedish cohort in the European Vertebral Osteoporosis Study. Osteoporos Int 14:61–68PubMedCrossRef
5.
Zurück zum Zitat Lindsay R, Silverman SL, Cooper C et al (2001) Risk of new vertebral fracture in the year following a fracture. JAMA 285:320–323PubMedCrossRef Lindsay R, Silverman SL, Cooper C et al (2001) Risk of new vertebral fracture in the year following a fracture. JAMA 285:320–323PubMedCrossRef
6.
Zurück zum Zitat Pongchaiyakul C, Nguyen ND, Jones G et al (2005) Asymptomatic vertebral deformity as a major risk factor for subsequent fractures and mortality: a long-term prospective study. J Bone Min Res 20:1349–1355CrossRef Pongchaiyakul C, Nguyen ND, Jones G et al (2005) Asymptomatic vertebral deformity as a major risk factor for subsequent fractures and mortality: a long-term prospective study. J Bone Min Res 20:1349–1355CrossRef
7.
Zurück zum Zitat Ismail AA, O’Neill TW, Cooper C et al (1998) Mortality associated with vertebral deformity in men and women: results from the European Prospective Osteoporosis Study (EPOS). Osteoporos Int 8:291–297PubMedCrossRef Ismail AA, O’Neill TW, Cooper C et al (1998) Mortality associated with vertebral deformity in men and women: results from the European Prospective Osteoporosis Study (EPOS). Osteoporos Int 8:291–297PubMedCrossRef
8.
Zurück zum Zitat Cooper C, Atkinson EJ, O’Fallon WM et al (1992) Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985–1989. J Bone Miner Res 7:221–227PubMedCrossRef Cooper C, Atkinson EJ, O’Fallon WM et al (1992) Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985–1989. J Bone Miner Res 7:221–227PubMedCrossRef
9.
Zurück zum Zitat Fink HA, Milavetz DL, Palermo L et al (2005) What proportion of incident radiographic vertebral deformities is clinically diagnosed and vice versa? J Bone Min Res 20:1216–1222CrossRef Fink HA, Milavetz DL, Palermo L et al (2005) What proportion of incident radiographic vertebral deformities is clinically diagnosed and vice versa? J Bone Min Res 20:1216–1222CrossRef
10.
Zurück zum Zitat Ettinger B, Black DM, Mitlak BH et al (1999) Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results froma 3-year randomized clinical trial. Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators. JAMA 282:637–645PubMedCrossRef Ettinger B, Black DM, Mitlak BH et al (1999) Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results froma 3-year randomized clinical trial. Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators. JAMA 282:637–645PubMedCrossRef
11.
Zurück zum Zitat Scane AC, Francis RM, Sutcliffe AM et al (1999) Case-control study of the pathogenesis and sequelae of symptomatic vertebral fractures in men. Osteoporos Int 9:91–97PubMedCrossRef Scane AC, Francis RM, Sutcliffe AM et al (1999) Case-control study of the pathogenesis and sequelae of symptomatic vertebral fractures in men. Osteoporos Int 9:91–97PubMedCrossRef
12.
Zurück zum Zitat Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–1733PubMedCrossRef Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–1733PubMedCrossRef
13.
Zurück zum Zitat Hasserius R, Karlsson MK, Jonsson B et al (2005) Long-term morbidity and mortality after a clinically diagnosed vertebral fracture in the elderly-a 12- and 22-year follow-up of 257 patients. Calcif Tissue Int 76:235–242PubMedCrossRef Hasserius R, Karlsson MK, Jonsson B et al (2005) Long-term morbidity and mortality after a clinically diagnosed vertebral fracture in the elderly-a 12- and 22-year follow-up of 257 patients. Calcif Tissue Int 76:235–242PubMedCrossRef
14.
Zurück zum Zitat Cooper C, Atkinson EJ, Jacobsen SJ et al (1993) Population-based study of survival after osteoporotic fractures. Am J Epidemiol 137:1001–1005PubMed Cooper C, Atkinson EJ, Jacobsen SJ et al (1993) Population-based study of survival after osteoporotic fractures. Am J Epidemiol 137:1001–1005PubMed
15.
Zurück zum Zitat Center JR, Nguyen TV, Schneider D et al (1999) Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet 353:878–888PubMedCrossRef Center JR, Nguyen TV, Schneider D et al (1999) Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet 353:878–888PubMedCrossRef
16.
Zurück zum Zitat Papaioannou A, Joseph L, Ioannidis G et al (2005) Risk factors associated with incident clinical vertebral and nonvertebral fractures in postmenopausal women: the Canadian Multicentre Osteoporosis Study (CaMos). Osteoporos Int 16:568–739PubMedCrossRef Papaioannou A, Joseph L, Ioannidis G et al (2005) Risk factors associated with incident clinical vertebral and nonvertebral fractures in postmenopausal women: the Canadian Multicentre Osteoporosis Study (CaMos). Osteoporos Int 16:568–739PubMedCrossRef
17.
Zurück zum Zitat Klotzbuecher CM, Ross PD, Landsman PB et al (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Min Res 15:721–739CrossRef Klotzbuecher CM, Ross PD, Landsman PB et al (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Min Res 15:721–739CrossRef
18.
Zurück zum Zitat Orwoll E, Blank JB, Barrett-Connor E et al (2005) Design and baseline characteristics of the Osteoporotic Fractures in Men (MrOS) study - a large observational study of the determinants of fracture in older men. Contemp Clin Trials 26:569–585PubMedCrossRef Orwoll E, Blank JB, Barrett-Connor E et al (2005) Design and baseline characteristics of the Osteoporotic Fractures in Men (MrOS) study - a large observational study of the determinants of fracture in older men. Contemp Clin Trials 26:569–585PubMedCrossRef
19.
Zurück zum Zitat Blank JB, Cawthon PM, Carrion-Petersen ML et al (2005) Overview of recruitment for the Osteoporotic Fractures in Men Study (MrOS). Contemp Clin Trials 26:557–568PubMedCrossRef Blank JB, Cawthon PM, Carrion-Petersen ML et al (2005) Overview of recruitment for the Osteoporotic Fractures in Men Study (MrOS). Contemp Clin Trials 26:557–568PubMedCrossRef
20.
Zurück zum Zitat Fried LP, Tangen CM, Walston J et al (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56:M146–M156PubMed Fried LP, Tangen CM, Walston J et al (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56:M146–M156PubMed
21.
Zurück zum Zitat Cawthon PM, Marshall LM, Michael Y et al, Frailty in Older Men: Prevalence, Progression and Relation to Mortality. Journal of the American Geriatrics Society. In Press Cawthon PM, Marshall LM, Michael Y et al, Frailty in Older Men: Prevalence, Progression and Relation to Mortality. Journal of the American Geriatrics Society. In Press
22.
Zurück zum Zitat Genant HK, Wu CY, Van Kuijk C et al (1993) Vertebral fracture assessment using a semiquantitative technique. J Bone Min Res 8:1137–1148 Genant HK, Wu CY, Van Kuijk C et al (1993) Vertebral fracture assessment using a semiquantitative technique. J Bone Min Res 8:1137–1148
23.
Zurück zum Zitat Looker AC, Wahner HW, Dunn WL et al (1998) Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int 8:468–489PubMedCrossRef Looker AC, Wahner HW, Dunn WL et al (1998) Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int 8:468–489PubMedCrossRef
24.
Zurück zum Zitat Van Staa TP, Dennison EM, Leufkens HGM et al (2001) Epidemiology of fractures in England and Wales. Bone 29:517–522PubMedCrossRef Van Staa TP, Dennison EM, Leufkens HGM et al (2001) Epidemiology of fractures in England and Wales. Bone 29:517–522PubMedCrossRef
25.
Zurück zum Zitat Melton LJ 3rd, Atkinson EJ, Cooper C et al (1999) Vertebral fractures predict subsequent fractures. Osteoporos Int 10:214–221PubMedCrossRef Melton LJ 3rd, Atkinson EJ, Cooper C et al (1999) Vertebral fractures predict subsequent fractures. Osteoporos Int 10:214–221PubMedCrossRef
26.
Zurück zum Zitat Sanders KM, Seeman E, Ugoni AM et al (1999) Age- and gender-specific rate of fractures in Australia: a population-based study. Osteoporos Int 10:240–247PubMedCrossRef Sanders KM, Seeman E, Ugoni AM et al (1999) Age- and gender-specific rate of fractures in Australia: a population-based study. Osteoporos Int 10:240–247PubMedCrossRef
27.
Zurück zum Zitat Kanis JA, Johnell O, Oden A et al (2000) Long-term risk of osteoporotic fracture in Malmo. Osteoporos Int 11:669–674PubMedCrossRef Kanis JA, Johnell O, Oden A et al (2000) Long-term risk of osteoporotic fracture in Malmo. Osteoporos Int 11:669–674PubMedCrossRef
28.
Zurück zum Zitat The European Prospective Osteoporosis Study (EPOS) Group (2002) The relationship between bone density and incident vertebral fracture in men and women. J Bone Min Res 17:2214–2221CrossRef The European Prospective Osteoporosis Study (EPOS) Group (2002) The relationship between bone density and incident vertebral fracture in men and women. J Bone Min Res 17:2214–2221CrossRef
29.
Zurück zum Zitat Van der Klift M, de Laet CEDH, McCloskey EV et al (2002) The incidence of vertebral fractures in men and women: the Rotterdam Study. J Bone Min Res 17:1051–1056CrossRef Van der Klift M, de Laet CEDH, McCloskey EV et al (2002) The incidence of vertebral fractures in men and women: the Rotterdam Study. J Bone Min Res 17:1051–1056CrossRef
30.
Zurück zum Zitat Kennedy RL, Grant PT, Blackwell D (2001) Low-impact falls: demands on a system of trauma management, prediction of outcome, and influence of comorbities. J Trauma 51:717–724PubMedCrossRef Kennedy RL, Grant PT, Blackwell D (2001) Low-impact falls: demands on a system of trauma management, prediction of outcome, and influence of comorbities. J Trauma 51:717–724PubMedCrossRef
31.
Zurück zum Zitat Orwoll ES, Lambert LC, Marshall LM et al (2006) Endogenous testosterone levels, physical performance, and fall risk in older men. Arch Intern Med 166:2124–2131PubMedCrossRef Orwoll ES, Lambert LC, Marshall LM et al (2006) Endogenous testosterone levels, physical performance, and fall risk in older men. Arch Intern Med 166:2124–2131PubMedCrossRef
32.
Zurück zum Zitat Cummings SR, Nevitt MC, Browner WS et al (1995) Risk factors for hip fracture in white women. N Engl J Med 332:767–773PubMedCrossRef Cummings SR, Nevitt MC, Browner WS et al (1995) Risk factors for hip fracture in white women. N Engl J Med 332:767–773PubMedCrossRef
33.
Zurück zum Zitat Cummings SR, Melton LJ 3rd (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359:1761–1767PubMedCrossRef Cummings SR, Melton LJ 3rd (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359:1761–1767PubMedCrossRef
34.
Zurück zum Zitat Szulc P, Munoz F, Duboeuf F et al (2005) Bone mineral density predicts osteoporotic fractures in elderly men - the MINOS Study. Osteoporos Int 16:1184–1192PubMedCrossRef Szulc P, Munoz F, Duboeuf F et al (2005) Bone mineral density predicts osteoporotic fractures in elderly men - the MINOS Study. Osteoporos Int 16:1184–1192PubMedCrossRef
35.
Zurück zum Zitat Cauley JA, Zmuda JM, Wisniewski SR et al (2004) Bone mineral density and prevalent vertebral fractures in men and women. Osteoporos Int 15:32–37PubMedCrossRef Cauley JA, Zmuda JM, Wisniewski SR et al (2004) Bone mineral density and prevalent vertebral fractures in men and women. Osteoporos Int 15:32–37PubMedCrossRef
36.
Zurück zum Zitat Nguyen TV, Eisman JA, Kelly PJ et al (1996) Risk factors for osteoporotic fractures in elderly men. Am J Epidemiol 144:255–263PubMed Nguyen TV, Eisman JA, Kelly PJ et al (1996) Risk factors for osteoporotic fractures in elderly men. Am J Epidemiol 144:255–263PubMed
37.
Zurück zum Zitat Cummings SR, Cawthon PM, Ensrud KE et al (2006) BMD and risk of hip and nonvertebral fractures in older men: a prospective study and comparison with older women. J Bone Min Res 21:1550–1555CrossRef Cummings SR, Cawthon PM, Ensrud KE et al (2006) BMD and risk of hip and nonvertebral fractures in older men: a prospective study and comparison with older women. J Bone Min Res 21:1550–1555CrossRef
38.
Zurück zum Zitat Siris ES, Miller PD, Barrett-Connor E et al (2001) Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women. Results from the National Osteoporosis Risk Assessment. JAMA 286:2815–2822PubMedCrossRef Siris ES, Miller PD, Barrett-Connor E et al (2001) Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women. Results from the National Osteoporosis Risk Assessment. JAMA 286:2815–2822PubMedCrossRef
39.
Zurück zum Zitat Schuit SCE, van der Klift M, Weel AEAM et al (2004) Fracture incidence and association with bone mineral density in elderly men and women: the Rotterdam Study. Bone 34:195–202PubMedCrossRef Schuit SCE, van der Klift M, Weel AEAM et al (2004) Fracture incidence and association with bone mineral density in elderly men and women: the Rotterdam Study. Bone 34:195–202PubMedCrossRef
40.
Zurück zum Zitat Szulc P, Munoz F, Duboeuf F et al (2006) Low width of tubular bones is associated with increased risk of fragility fracture in elderly men - the MINOS Study. Bone 38:595–602PubMedCrossRef Szulc P, Munoz F, Duboeuf F et al (2006) Low width of tubular bones is associated with increased risk of fragility fracture in elderly men - the MINOS Study. Bone 38:595–602PubMedCrossRef
41.
Zurück zum Zitat Riggs BL, Melton LJ 3rd, Robb RA et al (2006) Population-based analysis of the relationship of whole bone strength indices and fall-related loads to age- and sex-specific patterns of hip and wrist fractures. J Bone Min Res 21:315–323CrossRef Riggs BL, Melton LJ 3rd, Robb RA et al (2006) Population-based analysis of the relationship of whole bone strength indices and fall-related loads to age- and sex-specific patterns of hip and wrist fractures. J Bone Min Res 21:315–323CrossRef
42.
Zurück zum Zitat Myers ER, Wilson SE (1997) Biomechanics of osteoporosis and vertebral fractures. Spine 22:25S–31SPubMedCrossRef Myers ER, Wilson SE (1997) Biomechanics of osteoporosis and vertebral fractures. Spine 22:25S–31SPubMedCrossRef
43.
Zurück zum Zitat Kado DM, Duong T, Stone KL et al (2003) Incident vertebral fractures and mortality in older women: a prospective study. Osteoporos Int 14:589–594PubMedCrossRef Kado DM, Duong T, Stone KL et al (2003) Incident vertebral fractures and mortality in older women: a prospective study. Osteoporos Int 14:589–594PubMedCrossRef
44.
Zurück zum Zitat Woods NF, LaCroix AZ, Gray SL et al (2005) Frailty: emergence and consequences in women aged 65 and older in the Women’s Health Initiative Observational Study. J Am Geriatr Soc 53:1321–1330PubMedCrossRef Woods NF, LaCroix AZ, Gray SL et al (2005) Frailty: emergence and consequences in women aged 65 and older in the Women’s Health Initiative Observational Study. J Am Geriatr Soc 53:1321–1330PubMedCrossRef
45.
Zurück zum Zitat Samelson EJ, Hannan MT, Zhang Y et al (2006) Incidence and risk factors for vertebral fracture in women and men: 25-year follow-up results from the population-based Framingham Study. J Bone Min Res 21:1207–1214CrossRef Samelson EJ, Hannan MT, Zhang Y et al (2006) Incidence and risk factors for vertebral fracture in women and men: 25-year follow-up results from the population-based Framingham Study. J Bone Min Res 21:1207–1214CrossRef
Metadaten
Titel
Rate and circumstances of clinical vertebral fractures in older men
verfasst von
S. S. Freitas
E. Barrett-Connor
K. E. Ensrud
H. A. Fink
D. C. Bauer
P. M. Cawthon
L. C. Lambert
E. S. Orwoll
for the Osteoporotic Fractures in Men (MrOS) Research Group
Publikationsdatum
01.05.2008
Verlag
Springer-Verlag
Erschienen in
Osteoporosis International / Ausgabe 5/2008
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-007-0510-1

Weitere Artikel der Ausgabe 5/2008

Osteoporosis International 5/2008 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.