title: Association of stressful life events with incident falls and fractures in older men: the Osteoporotic Fractures in Men (MrOS) Study.
abstract: BACKGROUND
  small, retrospective studies suggest that major life events and/or sudden emotional stress may increase fall and fracture risk. The current study examines these associations prospectively.
  
  
  METHODS
  a total of 5,152 men aged ≥65 years in the Osteoporotic Fractures in Men study self-reported data on stressful life events for 1 year prior to study Visit 2. Incident falls and fractures were ascertained for 1 year after Visit 2. Fractures were centrally confirmed.
  
  
  RESULTS
  a total of 2,932 (56.9%) men reported ≥1 type of stressful life event. In men with complete stressful life event, fall and covariate data (n = 3,949), any stressful life event was associated with a 33% increased risk of incident fall [relative risk (RR) 1.33, 95% confidence interval (CI) 1.19-1.49] and 68% increased risk of multiple falls (RR = 1.68, 95% CI = 1.40-2.01) in the year following Visit 2 after adjustment for age, education, Parkinson's disease, diabetes, stroke, instrumental activities of daily living (IADL) impairment, chair stand time, walk speed, multiple past falls, depressive symptoms and antidepressant use. Risk increased with the number of types of stressful life events. Though any stressful life event was associated with a 58% increased age-adjusted risk for incident fracture, this association was attenuated and no longer statistically significant after additional adjustment for total hip bone mineral density, fracture after age 50, Parkinson's disease, stroke and IADL impairment.
  
  
  CONCLUSIONS
  in this cohort of older men, stressful life events significantly increased risk of incident falls independent of other explanatory variables, but did not independently increase incident fracture risk.
authors.affiliation: VA Medical Center, Geriatric Research Education and Clinical Center, One Veterans Drive, 11-G, Minneapolis, MN 55417, USA.
authors.forename: Howard A
authors.initials: HA
authors.lastname: Fink
authors.forename: Michael A
authors.initials: MA
authors.lastname: Kuskowski
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Marshall
mesh_terms: D000058:Accidental Falls; D000367:Age Factors; D000368:Aged; D006801:Humans; D015994:Incidence; D008016:Life Change Events; D008297:Male; D058866:Osteoporotic Fractures / Q000175:diagnosis / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013315:Stress, Psychological / Q000175:diagnosis / Q000453:epidemiology*; D013997:Time Factors; D014481:United States / Q000453:epidemiology
keywords: accidental falls; aged; fractures; life change events; male; men; older people; prospective studies; psychological stress