Fractures and mortality among elderly Japanese-American men living in Hawaii: the Honolulu heart program

Abstract

The risk and cost of osteoporotic fractures is steadily rising. With longer life expectancies and population growth of older people, the situation will only get worse. Most osteoporosis and fractures studies have focused on postmenopausal women because of the higher incidence of fractures related to a significant decrease in bone density after menopause, combined with a longer life expectancy of women. This has resulted in limited data related to fractures and subsequent mortality among elderly men. The purpose of this study is to examine the relationship between hip, spine, and forearm fractures as predictors of total mortality among elderly Japanese-American men, participating in the Honolulu Heart Program. The data from the Honolulu Heart Program (HHP)/Honolulu Asia Aging Study (HAAS) Exam4 (1991-1993) was used as the baseline, with the death of subjects being tracked though the year 2000. The average age, among the 3,845 male participants, was 77.9 years at baseline. A history of previous hip fracture was a predictor of total mortality, the risk was comparable to the mortality rate associated with being a current smoker. Anthropometric measurements including taller height, lower weight, lower BMI, higher WHR and lower grip strength of participants in their 70s, were associated with a higher risk of mortality after a hip fracture. The study suggests that interventions to retain muscle strength in midlife and in the elderly, may be helpful in preventing fractures and related deaths.