Any Fracture After 60 Raises Death Risk

Any fracture in older adults can be a signal of more trouble ahead, including early death, a study finds. The study included more than 4,000 people over age 60. It focused on 1,295 fractures in this group. All occurred after a low impact, such as a short fall. People who had such a fall were more likely to die than others in the next five years. After a broken hip, the extra risk lasted 10 years. But even breaks in bones such as the wrist increased the death risk. The study appeared in the Journal of the American Medical Association. HealthDay News wrote about it February 3.

What Is the Doctor's Reaction?

Osteoporosis is a common condition that increases the risk of bone fracture. But did you know that a broken bone related to this condition can also increase the risk of death?

Osteoporosis means "porous bones." All bones consist of a network of bone material and empty spaces. In osteoporosis, these empty spaces are larger than normal. This means the bones break easily.

Up to 1 out of 4 people who suffer a broken hip related to osteoporosis die within one year. It's never been clear whether these deaths are directly related to the fracture. It could be that the people have other medical problems that increase their risk of death.

A new study is among the best so far to explore the connection between these fractures and death. The study appears in the Journal of the American Medical Association.

The study included more than 4,000 people, ages 60 and older. Researchers from Australia kept track of them for up to 18 years. People in the group had 1,295 fractures related to osteoporosis. Researchers analyzed the falls and 658 deaths in the group.

Their findings were striking:

• For major fractures (pelvis, hip, spine or upper arm), the risk of death was increased for at least five years. This increased risk lasted up to 10 years for those with hip fractures.

• People with a minor fracture (lower arm, wrist, foot or collarbone) had higher death rates only if they were age 75 or older.

• People with a second fracture had an increased risk of death for another five years.

• Fractures of bones other than the hip or spine were common. In fact, they accounted for almost half of all fractures and nearly one-third of the increased death rate. This is a new finding. Most research in the past has not included these types of fractures.

• For men, being inactive also increased the risk of early death. For women, low bone mineral density and a history of smoking increased the risk. For men and women, other factors linked to higher death rates included advanced age and weak leg muscles.

These findings show that we should pay attention any time an older adult breaks a bone after a short fall or other minor trauma. This is called a low-impact fracture. Even fractures considered minor may predict an early death.

In my view, this study shows how we can reduce the risk of death after low-impact fractures. We can alter or eliminate factors that increase the risk of developing osteoporosis. More careful medical care after a fracture also may improve survival.

What Changes Can I Make Now?

It's still not clear whether fractures or other medical conditions are the cause of early death for people with osteoporosis. In either case, it makes sense to do what you can to reduce your risk of osteoporosis and fracture. For example:

• Exercise regularly. Weight-bearing exercises are particularly important.

• Be sure to get enough calcium and vitamin D. For adults, the recommended calcium intake from foods and supplements is 1,000 to 1,200 milligrams per day. Recommended vitamin D intake is 400 to 800 units each day. This National Institutes of Health has more information about calcium and vitamin D.

• Don't smoke.

• Drink only moderate amounts of alcohol. Women should have no more than one drink per day. Men should have no more than two drinks per day.

• Review your medicines with your doctor. Corticosteroids and excess thyroid hormone can lower bone density.

• If you are a woman over the age of 50 or a man over the age of 70, get regular tests of bone mineral density.

• Ask your doctor whether you should take a prescription drug to prevent osteoporosis and/or fractures. These medicines are usually reserved for people with low bone mineral density and a high risk of developing osteoporosis.

This new study suggests that older adults may need more vigilant care in the period after a fracture related to osteoporosis. If you have osteoporosis and have had a fracture, see your doctor regularly to review all of your medical problems.

What Can I Expect Looking to the Future?

This study is among the best to show a connection between fractures related to osteoporosis and early death. But it's still not clear why this connection exists. You can expect researchers to explore how a bone fracture increases the risk of death. This study may lead to new ways to increase survival for people who suffer fractures in fragile bones.