Can bone mineral density loss in the non-weight bearing distal forearm predict mortality?

Hauger, Annette V.<sup>1,2</sup>; Bergland, Astrid<sup>1</sup>; Holvik, Kristin<sup>2</sup>; Emaus, Nina<sup>3</sup>; Strand, Bjørn Heine<sup>2,4,5</sup>

Affiliations

¹Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Postboks 4 St. Olavs plass, 0130 Oslo, Norway

²Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Marcus Thranes gate 6, 0473 Oslo, Norway

³Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway

⁴Norwegian National Advisory Unit on Aging and Health, Vestfold, Hospital Trust, Tønsberg, Norway

⁵Faculty of Medicine, University of Oslo, Oslo, Norway

Abstract and keywords

Purpose: Low bone mineral density (BMD) is associated with increased risk of fractures and mortality. We investigated if rate of BMD loss in the distal forearm over seven years predicted mortality.

Methods: 1725 postmenopausal women and 1879 men aged 50–74 who participated in the longitudinal Tromsø Study waves 4 (1994–95) and 5 (2001−2002) were included. Cox regression models adjusted for lifestyle- and health related variables were used to assess associations between BMD change over seven years and subsequent mortality during up to 17 years of follow-up in participants with normal and low BMD at baseline.

Results: Baseline BMD decreased and seven-year bone loss increased with increasing age. Overall, mortality rates were higher among those with low versus normal BMD (38 vs 19 per 1000 py in women, 56 vs 34 in men) and at higher bone loss rates (rate ratio high:low = 1.2 in women, 1.7 in men). BMD change was associated with increased mortality only in men with normal baseline BMD. In this group, men with a BMD loss of >4% had significantly higher mortality (HR 1.50, 95% CI 1.21, 1.87) than men with increased or unchanged BMD. BMD change was not significantly associated with increased mortality in women or in men with low BMD at baseline.

Conclusions: BMD loss in the distal forearm was associated with increased mortality in men with normal BMD at baseline, but not in women. We found no clear association between BMD loss and mortality in those with low BMD at baseline.

Keywords: Bone mineral density; Osteoporosis; Osteopenia; Forearm; Mortality; Bone loss

Links

DOI: 10.1016/j.bone.2020.115347

PubMed: 32240848

WoS: 000535131500009

History

Received: 2019-12-12

Revised: 2020-03-27

Accepted: 2020-03-27

Online: 2020-03-30

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