Risk factors for proximal humerus, forearm, and wrist fractures in elderlymen and women - The Dubbo osteoporosis epidemiology study

Fractures of the proximal humerus, forearm, and wrist account for approxima tely one third of total osteoporotic fractures in the elderly. Several risk factors for these fractures were evaluated in this prospective study of 73 9 men and 1,105 women aged greater than or equal to 60 years in Dubbo, Aust ralia. During follow-up (1989-1996), the respective incidences of humerus a nd of forearm and wrist fractures, per 10,000 person-years, were 22.6 and 3 3.8 for men and 54.8 and 124.6 for women. Independent predictors of humerus fracture were femoral neck bone mineral density (FNBMD) (relative risk (RR ) = 2.3, 95% confidence interval (CI): 1.2, 4.5) in men and FNBMD (RR = 2.4 , 95% CI: 1.7, 3.5) and height loss (RR = 1.1, 95% CI: 1.0, 1.2) in women. For forearm and wrist fractures, risk factors were FNBMD (men: RR = 1.5, 95 % CI: 1.0, 2.3; women: RR = 1.5, 95% CI: 1.2, 1.9) and height loss (men: RR = 1.2, 95% CI: 1.0, 1.3; women: RR = 1.1, 95% CI: 1.0, 1.2). In addition, dietary calcium (men: RR = 2.0, 95% CI: 1.0, 3.6) and a history of falls (w omen: RR = 1.9, 95% Ci: 1.4, 2.6) were also significant. These data suggest that elderly men and women largely share common risk factors for upper lim b fractures and that FNBMD is the primary risk factor.