BONE-DENSITY AND RISK OF HIP FRACTURE IN MEN AND WOMEN - CROSS-SECTIONAL ANALYSIS

Objective: To determine the relative contribution of decline in bone d ensity to the increase in risk of hip fracture with age in men and wom en. Design: Incidence data of hip fracture from the general population were combined with the bone density distribution in a sample from the same population and with a risk estimate of low bone density known fi om literature. Setting: The Netherlands. Subjects: All people with a hospital admission for a hip fracture in 1993, and bone density measur ed in a sample of 5814 men and women aged 55 years and over in a distr ict of Rotterdam. Main outcome measure: One year cumulative risk of hi p fracture by age, sex, and bone density measured at the femoral neck. Results: A quarter of all hip fractures occurred in men. Men reached the same incidence as women at five years older. Controlled for age, t he risk of hip fracture by bone density was similar in men and women. The risk of hip fracture increased 13-fold from age 60 to 80; decrease in bone density associated with age contributed 1.9 (95% confidence i nterval 1.5 to 2.4) in women and 1.6 (1.3 to 1.8) in men. Conclusions: The risk of hip fracture by age and bone density is similar in men an d women. The decrease in bone density associated with age makes a limi ted contribution to the exponential increase of the risk of hip fractu re with age.