ACCELERATED BONE-MINERAL LOSS FOLLOWING A HIP FRACTURE - A PROSPECTIVE LONGITUDINAL-STUDY

The purpose of this prospective study was to monitor the bone mineral density (BRID) of the lumbar spine and contralateral femoral neck in t he first gear following an osteoporosis-related fracture of the hip, E ighty-three elderly patients (mean age 77 years) who had sustained a h ip fracture had determinations of BMD made at the time of fracture; 39 of these patients were available for reassessment of BMD 1 year later , The change in BMD was correlated with pre- and postinjury variables, such as ambulatory ability, dietary intake of calcium, serum vitamin D levels, mental status, and routine serologies, The mean decrease in BMD in the year following fracture was 5.4% from the contralateral fem oral neck and 2.4% from the lumbar spine, Calcium intake correlated wi th the loss of BMD from the femoral neck (p = 0.015), but not the lumb ar spine, Patients with daily calcium intakes of less than 500 mg/day had a more than 10% decrease in femoral neck BMD in the year following their hip fracture, Serum 1,25-dihydroxy vitamin D level correlated w ith toss of BMD from the lumbar spine (p = 0.001), but not from the fe moral neck, There was no correlation between the loss of bone mineral from either measurement site and age, sex, level of ambulation, or men tal status, The loss of BMD from the femoral neck in the year followin g a hip fracture is more than five times that reported in the nonfract ured population, This accelerated rate of loss can have drastic conseq uences in an elderly population already exhibiting osteopenia and prop ensity to fall, Investigation of pharmacologic or other interventions in the first critical gear following a hip fracture may potentially bl unt this accelerated rate of bone loss and lessen the risk of subseque nt fractures. (C) 1997 by Elsevier Science Inc. All rights reserved.