title: Osteoporosis medication and reduced mortality risk in elderly women and men.
abstract: BACKGROUND
  Osteoporotic fractures are associated with premature mortality. Antiresorptive treatment reduces refracture but mortality reduction is unclear.
  
  
  OBJECTIVE
  The objective of the study was to examine the effect of osteoporosis treatment [bisphosphonates (BP), hormone therapy (HT), and calcium ± vitamin D only (CaD)] on mortality risk.
  
  
  METHODS
  This was a prospective cohort study (April 1989 to May 2007).
  
  
  METHODS
  The study was conducted with community-dwelling elderly (aged 60+ yr) subjects in Dubbo, a semiurban city, Australia.
  
  
  METHODS
  Subjects included 1223 and 819 women and men in the Dubbo Osteoporosis Epidemiology Study.
  
  
  METHODS
  Mortality according to treatment group was recorded.
  
  
  RESULTS
  There were 325 (BP, n = 106; HT, n = 77; CaD, n = 142) women and 37 men (BP, n = 15; CaD, n = 22) on treatment. In women, mortality rates were lower with BP 0.8/100 person-years (0.4, 1.4) and HT 1.2/100 person-years (0.7, 2.1) but not CaD 3.2/100 person-years (2.5, 4.1) vs. no treatment 3.5/100 person-years (3.1, 3.8). Accounting for age, fracture occurrence, comorbidities, quadriceps strength, and bone mineral density, mortality risk remained lower for women on BP [hazard ratio (HR) 0.3 (0.2, 0.6)] but not HT [HR 0.8 (0.4, 1.8)]. For 429 women with fractures, mortality risk was still reduced in the BP group [adjusted HR 0.3 (0.2, 0.7)], not accounted for by a reduction in subsequent fractures. In men, lower mortality rates were observed with BP but not CaD [BP 1.0/100 person-years (0.3, 3.9) and CaD 3.1/100 person-years (1.5, 6.6) vs. no treatment 4.3/100 person-years (3.9, 4.8)]. After adjustment, mortality was similar, although not significant [HR 0.5 (0.1, 2.0)].
  
  
  CONCLUSIONS
  Osteoporosis therapy appears to reduce mortality risk in women and possibly men.
authors.affiliation: Garvan Institute of Medical Research, and St Vincent’s Hospital, Sydney, New South Wales, Australia. j.center@garvan.org.au
authors.forename: Jacqueline R
authors.initials: JR
authors.lastname: Center
authors.forename: Dana
authors.initials: D
authors.lastname: Bliuc
authors.forename: Nguyen D
authors.initials: ND
authors.lastname: Nguyen
authors.forename: Tuan V
authors.initials: TV
authors.lastname: Nguyen
authors.forename: John A
authors.initials: JA
authors.lastname: Eisman
mesh_terms: D000368:Aged / Q000706:statistics & numerical data*; D000369:Aged, 80 and over; D019386:Alendronate / Q000008:administration & dosage / Q000627:therapeutic use; D000465:Algorithms; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D015331:Cohort Studies; D015897:Comorbidity; D012968:Etidronic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D010024:Osteoporosis / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality; D058866:Osteoporotic Fractures / Q000453:epidemiology / Q000517:prevention & control; D000068296:Risedronic Acid; D012307:Risk Factors
chemical_list: D050071:Bone Density Conservation Agents; D000068296:Risedronic Acid; D012968:Etidronic Acid; D019386:Alendronate