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NEW YORK (Reuters Health) – - Research from Spain confirms that senior women are three times more likely than their male peers to fracture a hip but also finds risk factors differ for men and women.
Illiteracy and depression increase the risks of fracture for senior women, while smoking and disability raise the risk for senior men.
Dementia doesn’t increase the risk of hip fractures, but being married or having a partner does reduce the risk for men and women, say the authors.
Each year, more than 300,000 Americans over the age of 65 are hospitalized for hip fractures, according to the Centers for Disease Control and Prevention. About three out of four hip fractures occur in women.
The study, published in Maturitas, was led by Elena Lobo of the Department of Preventive Medicine and Public Health at Zaragoza University in Spain.
Lobo and colleagues analyzed medical and psychiatric histories for 4,803 adults in Zaragoza over the age of 55, including the number of hip fractures.
Participants were 73 years old, on average. Over the course of 16 years, about 8 percent of women broke a hip, compared to less than 3 percent of men.
Among the women in the study, being unable to read increased the risk of hip fracture by about 50 percent and being diagnosed with depression increased the risk by 44 percent.
For the men, smoking doubled the risk of hip fracture and being disabled tripled the risk.
“It is well documented that smoking is harmful to bone health,” Dr. Heike Bischoff-Ferrari told Reuters Health in an email.
“Additionally, most important at older age – smoking reduces calorie intake,” she added. The U.S. National Institutes of Health warns that being underweight is a risk factor for poor bone health.
Bischoff-Ferrari, who chairs the Geriatrics and Aging Research Department at University Hospital Zurich, Switzerland, said disability as a risk factor makes a lot of sense.
“Disability increases the risk of falling and falling is the primary risk factor for hip fractures,” said Bischoff-Ferrari, who wasn’t involved in the new study. “Disability also has a direct effect on bone and muscle health as disability reduces mobility – and thereby loss of both bone and muscle mass is the consequence – enhancing the risk of falls and hip fractures.”
Men who were coupled were half as likely to suffer a hip fracture and women who were married or lived with someone were 30 percent less likely to break a hip.
Bischoff-Ferrari said this finding also makes sense because seniors who live with a partner are less likely to be malnourished or depressed and more likely to have support with a possible disability.
"All of those risk factors have been associated with an increased risk of falling and sustaining a hip fracture," she said.
Bischoff-Ferrari said it's not clear why the study did not capture dementia as a risk factor when previous findings have shown that cognitive impairment is increasing the risk of falls and fractures.
"One explanation may be the correlation of risk factors – for example, we know that physical and cognitive impairment are closely correlated. The authors had both risk factors in their model, which may have led to the missing signal for dementia," she said.
She has some advice for reducing the risk of hip fractures.
“It is well documented that clearing the apartment of seniors from fall hazards, such as loose carpets, is effective, as is better lighting and hand grips to hold on to in the bathroom,” Bischoff-Ferrari said.
Bischoff-Ferrari said it’s also important to make sure that older adults are consuming an adequate number of calories. Their diet should focus on calcium and protein rich foods to prevention bone and muscle mass loss.
Bischoff-Ferrari added that exercise - for example, walking 30 minutes each day - has been shown to reduce the risk of hip fracture.
“Last but not least, a vitamin D supplement of 800 International Units per day has been shown to correct vitamin D deficiency and reduce falls and hip fractures by up to 30 percent,” she said.
The authors of the study did not respond to a request for comment.
SOURCE: bit.ly/2j5c9l1 Maturitas, online December 28, 2016.