Fracture risk in patients with Alzheimer's disease.
OBJECTIVE
To assess the risk of fracture following onset of Alzheimer's disease.


METHODS
Retrospective (historical) cohort study.


METHODS
Population-based in Rochester, Minnesota.


METHODS
All 543 Rochester residents with onset of Alzheimer's disease during the 10-year period, 1975-84, and an equal number of age- and sex-matched controls from the community.


METHODS
Fractures were assessed through review of each subject's complete (inpatient and outpatient) medical records in the community.


RESULTS
Rochester residents with Alzheimer's disease were no more likely to have a history of fracture prior to onset than were matched controls from the same population. During the year of onset, there was a 2-fold excess of fractures at various sites among those with Alzheimer's disease. The risk ratio for any fracture subsequently was 1.1 (95% CI 0.9, 1.3), and this slight increase was accounted for entirely by a 2.7-fold increase in the risk of hip fracture (95% CI 1.8, 4.2).


CONCLUSIONS
Fracture risk was not increased before the onset of Alzheimer's disease, although there was an excess of fractures around the time that Alzheimer's disease came to clinical attention. Fracture risk was not elevated thereafter except for a substantial increase in the risk of hip fracture. This suggests a link with certain falls rather than generalized disuse osteoporosis.
Melton
L J
LJ
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota 55905.
Beard
C M
CM
Kokmen
E
E
Atkinson
E J
EJ
O'Fallon
W M
WM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications* / Q000401:mortality; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D012189:Retrospective Studies; D012307:Risk Factors