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The epidemiology of wrist fractures in older men: the Osteoporotic Fractures in Men (MrOS) study

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Abstract

Summary

There is limited wrist fracture information on men. Our goal was to calculate frequency and identify risk factors for wrist fracture in the Osteoporotic Fractures in Men (MrOS) study. We confirmed that fracture history and certain medications are predictors, and identified novel predictors including markers of kidney function and physical performance.

Introduction

To calculate the incidence of wrist fractures and their risk factors in older community-dwelling men from the US Osteoporotic Fractures in Men (MrOS) study.

Methods

Using triannual postcards, we identified incident wrist fractures (centrally confirmed by radiology) in men aged ≥ 65. Potential risk factors included the following: demographics, lifestyle, bone mineral density (BMD), selected medications, biomarkers, and physical function and performance measures. Both baseline and time-varying models were adjusted for age, race/ethnicity, MrOS geographic location, and competing mortality risks.

Results

We observed 97 incident wrist fractures among 5875 men followed for an average of 10.8 years. The incidence of wrist fracture was 1.6 per 1000 person-years overall and ranged from 1.0 among men aged 65–69 to 2.4 among men age ≥ 80. Significant predictors included the following: fracture history after age 50 [hazard ratio (95% CI): 2.48 (1.65, 3.73)], high serum phosphate [1.25 (1.02, 1.53)], use of selective serotonin receptor inhibitor (SSRI) [3.60 (1.96, 6.63), decreased right arm BMD [0.49 (0.37, 0.65) per SD increase], and inability to perform the grip strength test [3.38 (1.24, 9.25)]. We did not find associations with factors commonly associated with wrist and other osteoporosis fractures like falls, diabetes, calcium and vitamin D intake, and alcohol intake.

Conclusions

Among these older, community-dwelling men, we confirmed that fracture history is a strong predictor of wrist fractures in men. Medications such as SSRIs and corticosteroids also play a role in wrist fracture risk. We identified novel risk factors including kidney function and the inability to perform the grip strength test.

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Funding

The Osteoporotic Fractures in Men (MrOS) Study is supported by the National Institutes of Health funding. The following institutes provide support: the National Institute on Aging (NIA), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Center for Advancing Translational Sciences (NCATS), and the NIH Roadmap for Medical Research under the following grant numbers: U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160, and UL1 TR000128. The Rancho Bernardo Study was funded by research grants AG028507 and AG007181 from the National Institute on Aging and grant DK31801 from the National Institute of Diabetes and Digestive and Kidney Diseases. NCW is supported by K12 HS023009. CMN is supported by K01 AR062655.

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Authors and Affiliations

  1. Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA

    N. C. Wright

  2. OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, OR, USA

    E. R. Hooker & C. M. Nielson

  3. Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN, USA

    K. E. Ensrud

  4. San Francisco Coordinating Center, University of California, San Francisco, San Francisco, CA, USA

    S. L. Harrison

  5. Division of Endocrinology, Oregon Health & Science University, Portland, OR, USA

    E. S. Orwoll

  6. Division of Epidemiology, Department of Family Medicine and Public Health, University of San Diego School of Medicine, La Jolla, CA, USA

    E. Barrett-Connor

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  1. N. C. Wright
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  2. E. R. Hooker
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  3. C. M. Nielson
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  4. K. E. Ensrud
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  6. E. S. Orwoll
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  7. E. Barrett-Connor
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for The Osteoporotic Fractures in Men (MrOS) Study Research Group

Corresponding author

Correspondence to E. Barrett-Connor.

Ethics declarations

The Institutional Review Board at each center approved the study protocols, and participants provided written informed consent.

Conflicts of interest

NCW: Research grant: Amgen; consultant: Pfizer

ERH: None

CMN: None

KEE: None

SLH: None

ESO: Research grants: Eli Lilly, Merck

EBC: None

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Wright, N.C., Hooker, E.R., Nielson, C.M. et al. The epidemiology of wrist fractures in older men: the Osteoporotic Fractures in Men (MrOS) study. Osteoporos Int 29, 859–870 (2018). https://doi.org/10.1007/s00198-017-4349-9

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