Age-Related Factors Associated With The Risk of Hip Fracture

Endocr Pract. 2023 Jun;29(6):478-483. doi: 10.1016/j.eprac.2023.03.001. Epub 2023 Mar 7.

Abstract

Objective: Advancing age is a powerful risk factor for hip fractures. The biological mechanisms through which aging impacts the risk of hip fractures have not been well studied.

Methods: Biological factors associated with "advancing age" that help to explain how aging is associated with the risk of hip fractures are reviewed. The findings are based on analyses of the Cardiovascular Health Study, an ongoing observational study of adults aged ≥65 years with 25 years of follow-up.

Results: The following 5 age-related factors were found to be significantly associated with the risk of hip fractures: (1) microvascular disease of the kidneys (albuminuria and/or elevated urine-albumin-to-creatinine ratio) and brain (abnormal white matter disease on brain magnetic resonance imaging); (2) increased serum levels of carboxymethyl-lysine, an advanced glycation end product that reflects glycation and oxidative stress; (3) reduced parasympathetic tone, as derived from 24-hour Holter monitoring; (4) carotid artery atherosclerosis in the absence of clinical cardiovascular disease; and (5) increased transfatty acid levels in the blood. Each of these factors was associated with a 10% to 25% increased risk of fractures. These associations were independent of traditional risk factors for hip fractures.

Conclusion: Several factors associated with older age help to explain how "aging" may be associated with the risk of hip fractures. These same factors may also explain the high risk of mortality following hip fractures.

Keywords: autonomic function; hip fracture; microvascular disease; oxidative stress; subclinical atherosclerosis; transfatty acids.

Publication types

  • Review

MeSH terms

  • Adult
  • Atherosclerosis*
  • Glycation End Products, Advanced
  • Hip Fractures* / epidemiology
  • Hip Fractures* / etiology
  • Humans
  • Longitudinal Studies
  • Observational Studies as Topic
  • Risk Factors

Substances

  • Glycation End Products, Advanced