Hip and back fractures increased mortality rates in people older than 50 years

Vertebral and hip fractures are associated with an increased mortality rate in individuals aged older than 50 years, according to a study published in the Canadian Medical Association Journal.

According to the five-year study, approximately 25% of people who develop a hip fracture and 16% who develop a spine fracture past the age of 50 will die within five years.

The research was part of the Canadian Multicentre Osteoporosis Study and included 2,187 men and 5,566 women. It differs from previous studies in that the group of participants involved was representative of the general population, according to the researchers. Individuals were recruited via telephone lists based on postal code areas.

“Hip fractures may have long-lasting effects that result in eventual death by signaling or actually inducing a progressive decline in health,” co-investigator George Ioannidis, PhD, wrote in the study. “Our results also showed that vertebral fracture was an independent predictor of death.”

The authors concluded that interventions such as osteoporosis medications, fall prevention strategies, hip protectors and enhanced rehabilitation after fracture must be introduced to improve mobility and strength.

In a related commentary, Maureen C. Ashe, PhD, BScPT, wrote that cognitive impairment and dementia are major risk factors for fractures, but patients with these conditions are often difficult to recruit and are thus underrepresented.

“If this was the case in this Canadian cohort (and it most likely was), the mortality data may contain ‘healthy volunteer bias’ and the population mortality rates may even be higher than reported by Ioannidis and his colleagues,” she wrote.

Ioannidis G. Can Med Assoc J. 2009;doi:10.1503/cmaj.081720.