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Trabecular, cortical BMD reductions associated with mortality risk
The risk for mortality is higher among adults with greater loss of trabecular and cortical bone compartments compared with adults with lower reductions, study data show.
Elisa A. Marques, PhD, of the National Institute on Aging at the NIH, and colleagues evaluated data from the AGES-Reykjavik study to determine the relationships between baseline trabecular and cortical volumetric bone mineral density at the proximal femur and rate of trabecular and cortical bone loss and all-cause mortality. At baseline, 4,654 participants aged at least 66 years were evaluated for trabecular and cortical volumetric BMD and mortality for a median follow-up of 9.4 years (AGES I), and 2,653 of those participants were evaluated for bone loss with a median follow-up of 5.6 years (AGES II).
In AGES I, 45.3% of participants died, and 16% of men and 31% of women sustained at least one fracture. In AGES II, 25.7% of participants died, and bone fracture incidence was 10.8% — 7.1% were men and 13.7% were women.
Evaluation of AGES I revealed that the risk for death was 1.21 times higher for participants in the lowest quartile of trabecular volumetric BMD compared with participants in the higher quartiles (P < .001) after adjustment for age, sex and hip size. Mortality was not related to baseline cortical volumetric BMD.
A mean 5.2 years separated the baseline visit (AGES I) and second visit (AGES II). Among participants who attended both study visits, loss in total hip trabecular volumetric BMD was greater in those who died (1.7% per year) compared with those who survived (1.4% per year). Mortality rate was higher among participants with more than 2% trabecular volumetric BMD loss per year (61 per 1,000 person years) compared with participants with less than 2% trabecular volumetric BMD loss per year (41 per 1,000 person years).
Participants with faster trabecular bone loss had an HR for mortality of 1.37 (95% CI, 1.15-1.64) compared with participants with slower trabecular bone loss. The HR was 1.33 (95% CI, 1.13-1.57) for participants in the faster quartiles of cortical bone loss at the proximal femur compared with those in the slower quartiles.
“The results illustrate that both cortical and trabecular bone loss were associated with higher risk of mortality,” the researchers wrote. “Advancing age is associated with bone loss and structural damage; however, the potential specific biologic factors that lead to both bone structure regulation and mortality risk is an important topic for future research.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.