title: Differences in the trajectory of bone mineral density change measured at the total hip and femoral neck between men and women following hip fracture.
abstract: Research has not examined changes in bone mineral density (BMD) between men and women following hip fracture. The aim was to evaluate sex differences in BMD following hip fracture. Men experienced significant declines in BMD, while not statistically greater than women, underscoring the necessity for better osteoporosis care in men.
  
  
  BACKGROUND
  Each year in the USA, approximately 260,000 older adults experience a hip fracture. Women experiencing hip fracture have excess decline in BMD in the year following fracture compared to expected decrements due to aging, but few studies have assessed sex differences in the sequelae of hip fracture. Thus, our objective was to examine sex differences in BMD change in the year after hip fracture.
  
  
  METHODS
  The sample (n = 286) included persons enrolled in the Baltimore Hip Studies 7th cohort, a study that matched (1:1) men and women experiencing hip fracture. Weighted estimating equations that accounted for missing data and selective survival were used to estimate sex differences in 12-month total hip (TH) and femoral neck (FN) BMD changes.
  
  
  RESULTS
  Men had larger average adjusted percent decline in TH and FN BMD. Adjusted 12-month decreases at the FN showed a statistically significant decline of -4.60% (95% confidence interval [CI] -7.76%, -0.20%) in men and an insignificant change of -1.62% (95% CI -4.57%, 1.32%) in women. Yet, the difference in change between men and women was not statistically significant (P = 0.17). The estimated sex differences for TH BMD loss were smaller in magnitude.
  
  
  CONCLUSIONS
  There is evidence of significant BMD loss among men at the FN in the year after hip fracture. Although not statistically greater than women, these clinically significant findings highlight the need for improved osteoporosis care among men prior to and after hip fracture.
authors: Department of Epidemiology and Public Health, University of Maryland School of Medicine, 660 W. Redwood Street, Howard Hall Suite 200, Baltimore, MD, 21201, USA. arathbun@epi.umaryland.edu.
authors: Alan M
authors: AM
authors: Rathbun
authors: National Institute on Aging, 251 Bayview Blvd, Baltimore, MD, 21224, USA.
authors: Michelle
authors: M
authors: Shardell
authors: Department of Epidemiology and Public Health, University of Maryland School of Medicine, 660 W. Redwood Street, Howard Hall Suite 200, Baltimore, MD, 21201, USA.
authors: Denise
authors: D
authors: Orwig
authors: Department of Epidemiology and Public Health, University of Maryland School of Medicine, 660 W. Redwood Street, Howard Hall Suite 200, Baltimore, MD, 21201, USA.
authors: J Richard
authors: JR
authors: Hebel
authors: University of Delaware, 540 S. College Ave, Suite 210E, Newark, DE, 19713, USA.
authors: Gregory E
authors: GE
authors: Hicks
authors: Beck Radiological Innovations, 922 Rambling Drive, Catonsville, MD, 21228, USA.
authors: Thomas
authors: T
authors: Beck
authors: Department of Epidemiology and Public Health, University of Maryland School of Medicine, 660 W. Redwood Street, Howard Hall Suite 200, Baltimore, MD, 21201, USA.
authors: Marc C
authors: MC
authors: Hochberg
authors: Department of Epidemiology and Public Health, University of Maryland School of Medicine, 660 W. Redwood Street, Howard Hall Suite 200, Baltimore, MD, 21201, USA.
authors: Jay
authors: J
authors: Magaziner
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology; D015519:Bone Density / Q000502:physiology*; D005260:Female; D005272:Femur Neck / Q000502:physiology; D006620:Hip Fractures / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000503:physiopathology*; D010384:Pelvic Bones / Q000502:physiology; D011446:Prospective Studies; D012727:Sex Characteristics
keywords: Aging; DXA; Hip fracture; Osteoporosis; Sex