Variation in risk factors for fractures at different sites.
Fractures in older people are important medical problems. Knowledge of risk factors is essential for successful preventive measures, but when fracture sites of diverse etiology are combined, risk factors for any one site are difficult to identify and may be missed entirely. Among older people, incidence rates of hip, proximal humerus, and vertebral fractures increase with age, but not rates of distal forearm and foot fractures. Low bone mineral density is strongly associated with hip, distal forearm, vertebral, and proximal humerus fractures, but not foot fracture. Most fractures of the hip, distal forearm, and proximal humerus result from a fall, whereas smaller proportions of fractures of the foot and vertebrae follow a fall. Frail people are likely to fracture their hip or proximal humerus, while healthy, active people tend to fracture their distal forearm. We strongly recommend that studies identify risk factors on a site-specific basis.
Kelsey
Jennifer L
JL
University of Massachusetts Medical School, Department of Medicine, Division of Preventive and Behavior Medicine, and Department of Family Medicine and Community Health, 55 Lake Place North, Shaw Building, Worcester MA 01655, USA. jennykelsey@comcast.net
Samelson
Elizabeth J
EJ
D000058:Accidental Falls; D000368:Aged; D005260:Female; D018409:Foot Injuries / Q000209:etiology; D005543:Forearm Injuries / Q000209:etiology; D050723:Fractures, Bone / Q000209:etiology* / Q000473:pathology; D005598:Fractures, Spontaneous / Q000209:etiology; D006620:Hip Fractures / Q000209:etiology; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000150:complications; D015663:Osteoporosis, Postmenopausal / Q000150:complications; D012307:Risk Factors; D012784:Shoulder Fractures / Q000209:etiology; D016103:Spinal Fractures / Q000209:etiology