Bone mineral density at the hip predicts mortality in elderly men

Low bone density as assessed by calcaneal ultrasound has been associated wi th mortality in elderly men and women. We examined the relationship between bone density measured at the hip and all cause and cardiovascular mortalit y in elderly men. Men aged 65-76 years from the general community were recr uited from general practices in Cambridge between 1991 and 1995. At baselin e survey, data collection included health questionnaires, measures of anthr opometry and cardiovascular risk factors, as well as bone mineral density ( BMD) measured using dual energy X-ray absorptiometry. All men have been fol lowed up for vital status up to December 1999. BMD was significantly invers ely related to mortality from all causes and cardiovascular disease, with d ecreasing rates with increasing bone density quartile, and an approximate h alving of risk between the bottom and top quartile (p <0.002, test for tren d all causes and p <0.025, test for trend for cardiovascular deaths). In mu ltivariate analyses using the Cox proportional hazards model, an increase o f 1 standard deviation (0.144 g/cm(2)) in total hip bone density was signif icantly associated with an age-adjusted 0.77 relative risk (95% Cl 0.66-0.9 1) for all-cause mortality and 0.76 relative risk (95% Cl 0.62-0.93) for ca rdiovascular disease mortality. The association remained significant after adjusting for age, body mass index, cigarette smoking status, serum cholest erol, systolic blood pressure, past history of heart attack, stroke or canc er and other lifestyle factors which included use of alcohol, physical acti vity and general health status. Low bone density at the hip is thus a stron g and independent predictor of all-cause and cardiovascular mortality in ol der men.