CORRELATES OF BONE-MINERAL DENSITY IN ELDERLY PATIENTS WITH HIP-FRACTURES

Ninety-seven elderly patients with acute fractures of the proximal fem ur sustained as a result of minimal trauma were studied with regard to variables that may potentially influence the incidence or outcome of fractures of the proximal femur. The mean bone mineral density (BMD) m easured at the femoral neck was similar to 2 SDs below age- and sex-ad justed normals. There was a preferential loss of bone mineral from the femoral neck in younger patients with hip fractures (Z score -3.10 +/ - 0.23) (mean +/- SEM) compared with the lumbar spine (Z score -1.71 /- 0.41). Mean daily calcium intake was well below the recommended lev els and calcium intake < 400 mg/day was associated with lower lumbar s pine BMD Z scores (p = 0.01). Ambulatory ability was unassociated with BMD Z scores. The results of this study suggest that the femoral neck is a site of preferential bone loss in younger postmenopausal patient s, and screening of patients at risk of hip fracture should measure BM D at this site. Calcium supplementation may play a role in decreasing the incidence of hip fractures.