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Original Investigation
May 11, 1998

Hip Fracture Risk in Older White Men Is Associated With Change in Body Weight From Age 50 Years to Old Age

Author Affiliations

From the Epidemiology, Demography and Biometry Program, National Institute on Aging, Bethesda, Md (Drs Langlois, Visser, and Harris); School of Medicine, University of Vermont, Burlington (Ms Davidovic); Istituto di Medicina Interna, University of Padua, Padua, Italy (Dr Maggi); and the Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, Md (Dr Li). Dr Langlois is now with the Centers for Disease Control and Prevention, Atlanta, Ga.

Arch Intern Med. 1998;158(9):990-996. doi:10.1001/archinte.158.9.990

Background  Change in body weight is a potentially modifiable risk factor for hip fracture in older women but, to our knowledge, its relationship to risk in older men has not been reported previously.

Objective  To investigate the effects of weight loss and weight gain from age 50 years to old age on the risk of hip fracture among elderly men.

Methods  The association between weight change and risk of hip fracture was studied in a cohort of 2413 community-dwelling white men aged 67 years or older from 3 sites of the Established Populations for Epidemiologic Study of the Elderly.

Results  The older men in this study, observed for a total of 13620 person-years during the 8 years of follow-up, experienced 72 hip fractures, yielding an overall incidence rate of 5.3 per 1000 person-years. Extreme weight loss (≥10%) beginning at age 50 years was associated in a proportional hazards model with increased risk of hip fracture (relative risk, 1.8; 95% confidence interval, 1.04-3.3). Weight loss of 10% or more was associated with several indicators of poor health, including physical disability, low mental status score, and low physical activity (P<.05). Weight gain of 10% or more beginning at age 50 years provided borderline protection against the risk of hip fracture (relative risk, 0.4; 95% confidence interval, 0.1-1.00).

Conclusions  Despite differences between older men and women in the incidence of and risk factors for hip fracture, weight history is also an important determinant of the risk of hip fracture among older men. Weight loss of 10% or more beginning at age 50 years increases the risk of hip fracture in older white men; weight gain of 10% or more decreases the risk of hip fracture. The relationship between extreme weight loss and poor health suggests that weight loss is a marker of frailty that may increase the risk of hip fracture in older men. Physicians should include weight history in their assessment of the risk of hip fracture among older men.