Ratio of Urine Albumin to Creatinine Attenuates the Association of Dementia With Hip Fracture Risk

Context: Microvascular disease is a leading cause of cognitive impairment. Approximately 50% of people with a hip fracture have cognitive impairment. Objective: We tested the hypothesis that microvascular diseases of the brain (lacunar infarcts and white matter disease [WMD]), kidney (albuminuria [≥ 30 mg/g creatinine] and albumin creatinine ratio [ACR]), and eye (retinal vascular disorders) attenuate the association of cognitive impairment with hip fracture risk. Setting: The Cardiovascular Health Cognition Study. Patients: Three thousand, one-hundred six participants (mean age, ∼79 y; 8.84 y median follow-up) with cognitive testing. Subsets received ACR testing (n=2389), brain magnetic resonance imaging scans (n = 2094), and retinal photography (n = 1098). Main Outcome Measure: Incident hip fracture. Results: There were 488 participants (16%) with mild cognitive impairment (MCI) and 564 (18%) with dementia. There were 337 incident hip fractures, of which 19% occurred in participants with MCI and 26% in participants with dementia. Adjusted hazard ratios (HR) and 95% confidence interval for hip fracture in participants with MCI were 2.45 (1.67–3.61) and for dementia 2.35 (1.57–3.52). With doubling of ACR, the HR for fracture was attenuated in participants with dementia compared with participants with normal cognition [interaction HR 0.70 (0.55–0.91)]. No such effect was found in participants with MCI. Albuminuria, lacunar infarcts, WMD, and retinal vascular disease (RVD) did not modify the association of dementia or MCI with hip fracture risk. Conclusions: ACR attenuates part of the risk of hip fracture in people with dementia, suggesting that these disorders share a common pathogenesis.

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Serum non-esterified fatty acid levels and hip fracture risk: The Cardiovascular Health Study

Osteoporosis International ◽

10.1007/s00198-021-05897-4 ◽

2021 ◽

Author(s):

J.I. Barzilay ◽

P. Buzkova ◽

L. Djoussé ◽

J. Ix ◽

J. Kizer ◽

...

Keyword(s):

Fatty Acid ◽

Hip Fracture ◽

Fracture Risk ◽

Cardiovascular Health ◽

Health Study ◽

Cardiovascular Health Study ◽

Hip Fracture Risk

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Potential Explanatory Factors for Higher Incident Hip Fracture Risk in Older Diabetic Adults

Current Gerontology and Geriatrics Research ◽

10.1155/2011/979270 ◽

2011 ◽

Vol 2011 ◽

pp. 1-8 ◽

Cited By ~ 14

Author(s):

Elsa S. Strotmeyer ◽

Aruna Kamineni ◽

Jane A. Cauley ◽

John A. Robbins ◽

Linda F. Fried ◽

...

Keyword(s):

Hip Fracture ◽

Fracture Risk ◽

Cardiovascular Health ◽

Health Study ◽

Cardiovascular Health Study ◽

Hip Fracture Risk ◽

Explanatory Factors ◽

Artery Disease ◽

Study Participants

Type 2 diabetes is associated with higher fracture risk. Diabetes-related conditions may account for this risk. Cardiovascular Health Study participants (N=5641; 42.0% men; 15.5% black; 72.8±5.6 years) were followed 10.9±4.6 years. Diabetes was defined as hypoglycemic medication use or fasting glucose (FG)≥126 mg/dL. Peripheral artery disease (PAD) was defined as ankle-arm index <0.9. Incident hip fractures were from medical records. Crude hip fracture rates (/1000 person-years) were higher for diabetic vs. non-diabetic participants with BMI <25 (13.6, 95% CI: 8.9–20.2 versus 11.4, 95% CI: 10.1–12.9) and BMI≥25 to <30 (8.3, 95% CI: 5.7–11.9 versus 6.6, 95% CI: 5.6–7.7), but similar for BMI≥30. Adjusting for BMI, sex, race, and age, diabetes was related to fractures (HR = 1.34; 95% CI: 1.01–1.78). PAD (HR = 1.25 (95% CI: 0.92–1.57)) and longer walk time (HR = 1.07 (95% CI: 1.04–1.10)) modified the fracture risk in diabetes (HR = 1.17 (95% CI: 0.87–1.57)). Diabetes was associated with higher hip fracture risk after adjusting for BMI though this association was modified by diabetes-related conditions.

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Association between Anti-Psychotic Drugs Use and Hip Fractures in Patients with Dementia: A Nationwide Population-Based Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158118 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8118

Author(s):

Chia-Hung Tang ◽

Yi-Chen Lai ◽

Yi-Chen Chen ◽

Shun-Min Chang ◽

Yu-Han Chen ◽

...

Keyword(s):

Hip Fracture ◽

Fracture Risk ◽

Hip Fractures ◽

Conditional Logistic Regression ◽

High Risk Group ◽

Control Analysis ◽

Hip Fracture Risk ◽

People With Dementia ◽

Increased Risk ◽

Four Levels

Background: People with dementia are a high-risk group for hip fractures. Although the increased risk of hip fractures associated with antipsychotic drugs (APD) is found in older populations, little is known about the risk for people with dementia living in Asia. We aimed to investigate the association between hip fractures and the characteristics of APD use in patients with dementia. Methods: A nested case-control analysis was conducted on a nationwide cohort in Taiwan. People with diagnoses of dementia during 2003–2012 were identified. Conditional logistic regression analysis was performed, and adjusted odds ratios (aORs) were calculated with a 95% confidence interval (CI) to estimate the risk of hip fractures. Results: APD use was associated with an increased risk of hip fractures in patients with dementia; current use or combined use of first and second generations of APDs had even higher risks. Regarding the duration of APD use, a U-shape curve of hip fracture risk was noted, and the risk peaked during 0–15 days and >215 days of exposure (aOR = 1.46, 95% CI 1.37–1.57; aOR = 1.47, 95% CI 1.37–1.58; respectively). Considering the doses of APDs, the hip fracture risk was significantly increased with all four levels of the cumulative doses and average daily doses and peaked in the group with the highest average daily dose. Conclusions: The findings suggest that caution must be taken when initiating APD use in patients with dementia, even in a small dose, and mixed types of APD prescriptions should be administered with care. Furthermore, frequent evaluation of the possibility of tapering or withdrawal of the medication is necessary, as the risk does not attenuate after long-term use.

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