American Journal of Epidemiology Vol. 153, No. 6 : 587-595
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Risk Factors for Proximal Humerus, Forearm, and Wrist Fractures in Elderly Men and Women The Dubbo Osteoporosis Epidemiology Study
1 Bone and Mineral Research Program, Garvan Institute of Medical Research, St. Vincent's Hospital, Sydney, Australia.
2 Present address: The Simpson Centre, University of New South Wales, Liverpool Hospital, Liverpool, New South Wales, Australia.
3 Present address: Department of Rheumatology, Royal North Shore Hospital, St. Leonards, New South Wales, Australia.
Fractures of the proximal humerus, forearm, and wrist account for approximately one third of total osteoporotic fractures in the elderly. Several risk factors for these fractures were evaluated in this prospective study of 739 men and 1,105 women aged 
60 years in Dubbo, Australia. During follow-up (1989–1996), the respective incidences of humerus and of forearm and wrist fractures, per 10,000 person-years, were 22.6 and 33.8 for men and 54.8 and 124.6 for women. Independent predictors of humerus fracture were femoral neck bone mineral density (FNBMD) (relative risk (RR) = 2.3, 95% confidence interval (CI): 1.2, 4.5) in men and FNBMD (RR = 2.4, 95% CI: 1.7, 3.5) and height loss (RR = 1.1, 95% CI: 1.0, 1.2) in women. For forearm and wrist fractures, risk factors were FNBMD (men: RR = 1.5, 95% CI: 1.0, 2.3; women: RR = 1.5, 95% CI: 1.2, 1.9) and height loss (men: RR = 1.2, 95% CI: 1.0, 1.3; women: RR = 1.1, 95% CI: 1.0, 1.2). In addition, dietary calcium (men: RR = 2.0, 95% CI: 1.0, 3.6) and a history of falls (women: RR = 1.9, 95% CI: 1.4, 2.6) were also significant. These data suggest that elderly men and women largely share common risk factors for upper limb fractures and that FNBMD is the primary risk factor.
aged; bone density; forearm; fractures; humeral fractures; humerus; osteoporosis; prospective studies
Abbreviations: BMD, bone mineral density; CI, confidence interval
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