Effect of Multimorbidity on Fragility Fractures in Community-Dwelling Older Adults: Shimane CoHRE Study.

Garu A,Aorigele Yu,Miwako Takeda,Abdullah Md Sheik,Minoru Isomura,Kunie Kohno,Shozo Yano,Atsushi Nagai,Toru Nabika,Masayuki Yamasaki,Kenta Okuyama

doi:10.3390/jcm10153225

Abstract

Fragility fractures (FFxs), which are a common musculoskeletal injury in older adults, is associated with an increased frequency of falls. Both FFxs and falls may result from drugs, habits, and co-occurring diseases. We aimed to evaluate the effects of various diseases on the risk of FFx. This retrospective study included 1420 individuals aged ≥60 years. We evaluated the history of clinical FFx and diseases using a detailed questionnaire and a health examination. The risk of comorbidities was assessed using the Age-Adjusted Charlson Comorbidity (AAC) Index. We performed binary logistic regression analysis to determine the risk of FFx and falls after adjusting for covariates. In elderly men, the incidence of FFx positively correlated with rheumatoid arthritis and parent’s hip fracture. For elderly women, the incidence of FFx positively correlated with rheumatoid arthritis and antihypertensive drugs but was inversely associated with dyslipidemia and antilipidemic drugs. The FFX risk of older adults with an AAC Index ≥6 was higher than those with an AAC Index of 1–3. In addition, the AAC Index and falls were independently and strongly associated with a higher risk of FFx. Taken together, multimorbidity increases the risk of clinical FFx independent of falls in the community-dwelling elderly population.

Highlights

Bone fractures are one of the most common musculoskeletal injuries
The chi-square test showed a significant difference in the incidence of fragility fracture (FFx) in both men and women with RA, suggesting that elderly men and women with RA have a higher risk of FFx (Table 1)
The results suggested that reduced usual walking speed and increased frequency of falls conferred a higher risk of FFx in elderly women

Summary

Introduction

Bone fractures are one of the most common musculoskeletal injuries. Evidence of the relationship between lifestyle diseases and fractures has been recently published, and it was reported that the elderly with certain diseases, such as diabetes [1], hypertension [2], chronic obstructive pulmonary disease (COPD) [3], and chronic kidney disease (CKD) [4], are at a higher risk of fracture than the general population. Fragility fractures (FFx) affect the quality of life and are associated with increased morbidity and mortality. Besides steroids [5], the widespread use of drugs, such as sedatives [6], psychotropics [7] and antihypertensives, may increase the risk of falls and fracture. Several other factors can influence bone health, such as lifestyle habits, including physical activity, diet, smoking, and alcohol consumption [8]. A history of hip fracture and low adherence to

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