Prevalence of osteoporosis, osteopenia, fall and brittle fracture and their associated factors in men aged 80 years and over

Abstract

Objective To investigate the prevalence of osteoporosis, osteopenia, fall and brittle fracture and their associated factors in men aged 80 years and over. Methods In a prospective study, 184 study subjects with good self-care ability aged 80 years and over were enrolled.The questionnaire included living habits, falls, comorbidities, related symptoms and medicines.The bone mineral density, hand-grip strength, gait speed, timed up and go test(TUG), chair rising test(CRT), bone turnover markers and related hormones were measured.Binary Logistic regression model was used to analyze associated factors for osteoporosis, osteopenia, fall and brittle fracture. Results The prevalence of osteoporosis(OP)and osteopenia(OPA)were 12.5%(23/184)and 45.1%(83/184)respectively in this study.The height, weight and body mass index were lower, and serum levels of procollagen type 1 N-terminal propeptide(P1NP)and C-telopeptides of type 1 collagen(s-CTx)were higher in osteoporosis group than in normal bone mass(NBM)group(P<0.05, P<0.01). The estradiol levels were lower in OP and OPA group than in NBM group(P<0.05). The risk factors for OP and OPA included smoking(OR=3.607, P<0.05), decreased body weight(OR=0.823, P<0.05)and elevated S-CTx level(OR=12.427, P<0.01).55.4%(102/184)of study subjects had fall history after 80-year-old.The prevalence of fragile fracture was 17.4%(4/23), 18.1%(15/83)and 3.8%(3/78)in OP, OPA and NBM groups respectively, with total prevalence of 12.0%(22/184). The risk factors for fragile fracture were a decreased total hip BMD(OR=0.017, P<0.05)and fall history after 80-year-old(OR=13.126, P<0.05). Conclusions Based on associated factors of osteoporosis, osteopenia, falls and fragile fracture in male aged 80 years and over, the primary and secondary prevention of osteoporosis may need a comprehensive geriatric intervention including lifestyle adjustment, fall prevention and pharmacologic treatments. Key words: Osteoporosis; Fracture, bone; Accidental falls