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. 2007 Apr;99(4):412–418.

History of fractures as predictor of subsequent hip and nonhip fractures among older Mexican Americans.

Folasade Ojo 1, Soham Al Snih 1, Laura A Ray 1, Mukaila A Raji 1, Kyriakos S Markides 1
PMCID: PMC2569658  PMID: 17444431

Abstract

OBJECTIVE: To examine the association between previous fracture and risk of new hip and nonhip fractures over a seven-year period among older Mexican Americans. METHOD: Data used are from the Hispanic Established Population for the Epidemiological Study of the Elderly (H-EPESE) (1993-2001). Measures included history of previous fracture (hip fracture only, a nonhip fracture, hip and nonhip fractures, and no fractures), sociodemographic factors, smoking status, medical conditions (arthritis, diabetes, stroke and cancer), activities of daily living disability, and high depressive symptoms. Cox proportional regression model was used to estimate the seven-year incidence of fractures. RESULTS: Of the 2,589 subjects, 42 reported a hip fracture, 328 reported a nonhip fracture, and 2,219 did not report a fracture at baseline. After controlling for all covariates, the hazard ratio (HR) of new hip fracture at seven-year follow-up was 6.48 (95% CI: 3.26-12.97) for subjects with only hip fracture at baseline and 1.96 (95% CI: 1.22-3.16) for subjects with nonhip fracture at baseline. The HR of new nonhip fracture was 1.90 (95% CI: 0.96-3.77) for subjects with only hip fracture at baseline and 2.62 (95% CI: 1.95-3.52) for subjects with nonhip fracture at baseline. CONCLUSIONS: A previous history of fractures in older Mexican Americans is the strongest predictor of recurrent fractures at hip and nonhip sites, independent of other health measures. Our findings of recurrent fractures suggest the need for more aggressive detection and adequate treatment of osteoporosis- and fall-related factors in this population.

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Selected References

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  1. Boyd J. H., Weissman M. M., Thompson W. D., Myers J. K. Screening for depression in a community sample. Understanding the discrepancies between depression symptom and diagnostic scales. Arch Gen Psychiatry. 1982 Oct;39(10):1195–1200. doi: 10.1001/archpsyc.1982.04290100059010. [DOI] [PubMed] [Google Scholar]
  2. Branch L. G., Katz S., Kniepmann K., Papsidero J. A. A prospective study of functional status among community elders. Am J Public Health. 1984 Mar;74(3):266–268. doi: 10.2105/ajph.74.3.266. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Burnette D., Mui A. C. Physician utilization by Hispanic elderly persons: national perspective. Med Care. 1999 Apr;37(4):362–374. doi: 10.1097/00005650-199904000-00006. [DOI] [PubMed] [Google Scholar]
  4. Center J. R., Nguyen T. V., Schneider D., Sambrook P. N., Eisman J. A. Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet. 1999 Mar 13;353(9156):878–882. doi: 10.1016/S0140-6736(98)09075-8. [DOI] [PubMed] [Google Scholar]
  5. Colón-Emeric Cathleen, Kuchibhatla Maragatha, Pieper Carl, Hawkes William, Fredman Lisa, Magaziner Jay, Zimmerman Sheryl, Lyles Kenneth W. The contribution of hip fracture to risk of subsequent fractures: data from two longitudinal studies. Osteoporos Int. 2003 Oct 3;14(11):879–883. doi: 10.1007/s00198-003-1460-x. [DOI] [PubMed] [Google Scholar]
  6. Cooper C., Atkinson E. J., Jacobsen S. J., O'Fallon W. M., Melton L. J., 3rd Population-based study of survival after osteoporotic fractures. Am J Epidemiol. 1993 May 1;137(9):1001–1005. doi: 10.1093/oxfordjournals.aje.a116756. [DOI] [PubMed] [Google Scholar]
  7. Cooper C., Atkinson E. J., Jacobsen S. J., O'Fallon W. M., Melton L. J., 3rd Population-based study of survival after osteoporotic fractures. Am J Epidemiol. 1993 May 1;137(9):1001–1005. doi: 10.1093/oxfordjournals.aje.a116756. [DOI] [PubMed] [Google Scholar]
  8. Cuddihy M. T., Gabriel S. E., Crowson C. S., O'Fallon W. M., Melton L. J., 3rd Forearm fractures as predictors of subsequent osteoporotic fractures. Osteoporos Int. 1999;9(6):469–475. doi: 10.1007/s001980050172. [DOI] [PubMed] [Google Scholar]
  9. Cummings S. R., Black D. M., Rubin S. M. Lifetime risks of hip, Colles', or vertebral fracture and coronary heart disease among white postmenopausal women. Arch Intern Med. 1989 Nov;149(11):2445–2448. [PubMed] [Google Scholar]
  10. Diamond T. H., Thornley S. W., Sekel R., Smerdely P. Hip fracture in elderly men: prognostic factors and outcomes. Med J Aust. 1997 Oct 20;167(8):412–415. doi: 10.5694/j.1326-5377.1997.tb126646.x. [DOI] [PubMed] [Google Scholar]
  11. Espino D. V., Palmer R. F., Miles T. P., Mouton C. P., Wood R. C., Bayne N. S., Markides K. P. Prevalence, incidence, and risk factors associated with hip fractures in community-dwelling older Mexican Americans: results of the Hispanic EPESE study. Establish Population for the Epidemiologic Study for the Elderly. J Am Geriatr Soc. 2000 Oct;48(10):1252–1260. doi: 10.1111/j.1532-5415.2000.tb02598.x. [DOI] [PubMed] [Google Scholar]
  12. Folstein M. F., Folstein S. E., McHugh P. R. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189–198. doi: 10.1016/0022-3956(75)90026-6. [DOI] [PubMed] [Google Scholar]
  13. Guralnik J. M., Ferrucci L., Simonsick E. M., Salive M. E., Wallace R. B. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med. 1995 Mar 2;332(9):556–561. doi: 10.1056/NEJM199503023320902. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Heyburn Gary, Beringer Timothy, Elliott James, Marsh David. Orthogeriatric care in patients with fractures of the proximal femur. Clin Orthop Relat Res. 2004 Aug;(425):35–43. doi: 10.1097/01.blo.0000131492.01669.51. [DOI] [PubMed] [Google Scholar]
  15. Iqbal M. M. Osteoporosis: epidemiology, diagnosis, and treatment. South Med J. 2000 Jan;93(1):2–18. doi: 10.1097/00007611-200093010-00002. [DOI] [PubMed] [Google Scholar]
  16. Klotzbuecher C. M., Ross P. D., Landsman P. B., Abbott T. A., 3rd, Berger M. Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res. 2000 Apr;15(4):721–739. doi: 10.1359/jbmr.2000.15.4.721. [DOI] [PubMed] [Google Scholar]
  17. Leibson Cynthia L., Tosteson Anna N. A., Gabriel Sherine E., Ransom Jeanine E., Melton L. Joseph. Mortality, disability, and nursing home use for persons with and without hip fracture: a population-based study. J Am Geriatr Soc. 2002 Oct;50(10):1644–1650. doi: 10.1046/j.1532-5415.2002.50455.x. [DOI] [PubMed] [Google Scholar]
  18. Looker A. C., Orwoll E. S., Johnston C. C., Jr, Lindsay R. L., Wahner H. W., Dunn W. L., Calvo M. S., Harris T. B., Heyse S. P. Prevalence of low femoral bone density in older U.S. adults from NHANES III. J Bone Miner Res. 1997 Nov;12(11):1761–1768. doi: 10.1359/jbmr.1997.12.11.1761. [DOI] [PubMed] [Google Scholar]
  19. Looker A. C., Wahner H. W., Dunn W. L., Calvo M. S., Harris T. B., Heyse S. P., Johnston C. C., Jr, Lindsay R. Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int. 1998;8(5):468–489. doi: 10.1007/s001980050093. [DOI] [PubMed] [Google Scholar]
  20. Maggi S., Kelsey J. L., Litvak J., Heyse S. P. Incidence of hip fractures in the elderly: a cross-national analysis. Osteoporos Int. 1991 Sep;1(4):232–241. doi: 10.1007/BF03187467. [DOI] [PubMed] [Google Scholar]
  21. Mamdani Muhammad, Upshur Ross E. G., Anderson Geoff, Bartle Bill R., Laupacis Andreas. Warfarin therapy and risk of hip fracture among elderly patients. Pharmacotherapy. 2003 Jan;23(1):1–4. doi: 10.1592/phco.23.1.1.31922. [DOI] [PubMed] [Google Scholar]
  22. Markides K. S., Stroup-Benham C. A., Goodwin J. S., Perkowski L. C., Lichtenstein M., Ray L. A. The effect of medical conditions on the functional limitations of Mexican-American elderly. Ann Epidemiol. 1996 Sep;6(5):386–391. doi: 10.1016/s1047-2797(96)00061-0. [DOI] [PubMed] [Google Scholar]
  23. Melton L. J., 3rd, Chrischilles E. A., Cooper C., Lane A. W., Riggs B. L. Perspective. How many women have osteoporosis? J Bone Miner Res. 1992 Sep;7(9):1005–1010. doi: 10.1002/jbmr.5650070902. [DOI] [PubMed] [Google Scholar]
  24. Melton L. J., 3rd Who has osteoporosis? A conflict between clinical and public health perspectives. J Bone Miner Res. 2000 Dec;15(12):2309–2314. doi: 10.1359/jbmr.2000.15.12.2309. [DOI] [PubMed] [Google Scholar]
  25. Nevitt M. C., Ross P. D., Palermo L., Musliner T., Genant H. K., Thompson D. E. Association of prevalent vertebral fractures, bone density, and alendronate treatment with incident vertebral fractures: effect of number and spinal location of fractures. The Fracture Intervention Trial Research Group. Bone. 1999 Nov;25(5):613–619. doi: 10.1016/s8756-3282(99)00202-1. [DOI] [PubMed] [Google Scholar]
  26. Ray N. F., Chan J. K., Thamer M., Melton L. J., 3rd Medical expenditures for the treatment of osteoporotic fractures in the United States in 1995: report from the National Osteoporosis Foundation. J Bone Miner Res. 1997 Jan;12(1):24–35. doi: 10.1359/jbmr.1997.12.1.24. [DOI] [PubMed] [Google Scholar]

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