Effects of height loss on morbidity and mortality in 3145 community-dwelling Chinese older women and men: a 5-year prospective study.
BACKGROUND
height loss beginning in mid-life and post-menopausal period was associated with adverse health outcomes. However, height loss occurring after old age has been little studied. We examined how height loss was related to bone mineral density (BMD) change, fracture incidence and cause-specific mortality in older adults.


METHODS
the stature and BMD of 3145 community-dwelling men and women aged ≥65 were measured at baseline and after 4 years. All fracture and cause-specific mortality events were searched in a territory-wide clinical information database and death registry.


RESULTS
twenty-five (1.6%) men and 64 (4.0%) women lost >2 cm after 4 years. In women, the BMD decline was faster in the rapid height losers (adjusted difference = 4.18%, P < 0.001). There was no corresponding difference observed in men. Rapid height loss was associated with excess all fractures and hip fractures (adjusted HR for all fractures = 2.86, P < 0.001; adjusted HR for hip fractures = 4.74, P < 0.01) in women but only hip fractures (adjusted HR = 4.93, P < 0.05) in men. The all-cause (adjusted HR = 3.43, P < 0.01) and respiratory disease mortality (adjusted HR = 5.64, P < 0.05) were higher in men with rapid height loss, whereas those in women were insignificant.


CONCLUSIONS
modest height loss occurring after old age, >2 cm in 4 years, was associated with excess hip fracture, total and respiratory disease mortality in older men. In women, it was associated with excess BMD decline, all fractures and hip fractures but not mortality. Further research is needed to determine the usefulness of regular stature measurement as an indicator of bone health in the primary-care setting in older adults.
Auyeung
Tung Wai
TW
Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong. auyeungtw@cuhk.edu.hk
Lee
Jenny Shun Wah
JS
Leung
Jason
J
Kwok
Timothy
T
Leung
Ping Chung
PC
Woo
Jean
J
D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data*; D001827:Body Height; D015519:Bone Density; D005260:Female; D006620:Hip Fractures / Q000208:ethnology / Q000401:mortality*; D006801:Humans; D015994:Incidence; D008297:Male; D009017:Morbidity; D010024:Osteoporosis / Q000208:ethnology / Q000401:mortality*; D011320:Primary Health Care / Q000706:statistics & numerical data; D011446:Prospective Studies; D012042:Registries; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012307:Risk Factors; D017678:Sex Distribution
J Gerontol A Biol Sci Med Sci. 2007 Jun;62(6):652-7
17595423
Osteoporos Int. 2007 Sep;18(9):1261-9
17387421
Am J Epidemiol. 1999 Nov 1;150(9):969-77
10547143
J Clin Epidemiol. 1993 Feb;46(2):153-62
8437031
Osteoporos Int. 2006 Feb;17(2):297-303
16175311
Osteoporos Int. 2006 Feb;17(2):290-6
16143833
J Nutr Health Aging. 2009 Dec;13(10):931-6
19924356
Osteoporos Int. 2008 Jan;19(1):21-8
17962917
Osteoporos Int. 1998;8(3):261-7
9797911
Osteoporos Int. 2005 Apr;16(4):403-10
15309381
J Rheumatol. 2004 Apr;31(4):747-52
15088302
J Bone Miner Res. 2008 Mar;23(3):425-32
17997714
Osteoporos Int. 2006;17(6):834-40
16575617
Osteoporos Int. 2007 Nov;18(11):1493-9
17541811
Osteoporos Int. 1998;8(1):75-81
9692081
J Orthop Res. 2006 May;24(5):1086-94
16609964
J Clin Densitom. 2006 Jan-Mar;9(1):37-46
16731430
J Clin Densitom. 2004 Spring;7(1):65-70
14742889
Spine (Phila Pa 1976). 1994 Jun 1;19(11):1250-5
8073317
Arch Intern Med. 2006 Dec 11-25;166(22):2546-52
17159023
J Am Geriatr Soc. 2004 Jun;52(6):909-15
15161454