Clinical Risk Factors for Fractures in Multi‐Ethnic Women: The Women's Health Initiative

To identify risk factors for fractures in multi‐ethnic women, we studied 159,579 women enrolled in the Women's Health Initiative. In general, risk factors for fractures were similar across ethnic groups. However, irrespective of their ethnicity, women with multiple risk factors have a high risk of fracture. Targeting these high‐risk women for screening and intervention could reduce fractures.

[1]  R. Senie,et al.  Low body weight as a risk factor for hip fracture in both black and white women , 1989, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[2]  R. Keller,et al.  Basic Epidemiology of Fractures of the Upper and Lower Limb among Americans over 65 Years of Age , 1996, Epidemiology.

[3]  M. Holick,et al.  Prevalence of Vitamin D inadequacy among postmenopausal North American women receiving osteoporosis therapy. , 2005, The Journal of clinical endocrinology and metabolism.

[4]  M. Karagas,et al.  Fracture risk in the U.S. Medicare population. , 1999, Journal of clinical epidemiology.

[5]  S. Silverman,et al.  Increasing hip fracture incidence in California Hispanics, 1983 to 2000 , 2004, Osteoporosis International.

[6]  R. Palmer,et al.  Prevalence, incidence, and risk factors associated with hip fractures in community-dwelling older Mexican Americans: results of the Hispanic EPESE study. Establish Population for the Epidemiologic Study for the Elderly. , 2000, Journal of the American Geriatrics Society.

[7]  J. Kelsey,et al.  Risk factors for hip fracture in men. Hip Fracture Study Group. , 1997, American journal of epidemiology.

[8]  J. Kelsey,et al.  Risk Factors for Hip Fracture in Men , 1997 .

[9]  R. Palmer,et al.  Prevalence, Incidence, and Risk Factors Associated with Hip Fractures in Community‐Dwelling Older Mexican Americans: Results of the Hispanic EPESE Study , 2000, Journal of the American Geriatrics Society.

[10]  D. Bauer.  Thyroid hormone use and fractures. , 1996, Archives of internal medicine.

[11]  K. Ensrud,et al.  Body Size and Risk for Clinical Fractures in Older Women , 2000, Annals of Internal Medicine.

[12]  J. Cauley,et al.  DEPRESSION, FALLS, AND RISK OF FRACTURE IN OLDER WOMEN , 1999 .

[13]  Euni Lee,et al.  Osteoporotic fragility fractures in African Americans: under-recognized and undertreated. , 2004, Journal of the National Medical Association.

[14]  A. Bayat,et al.  Science, medicine, and the future: Bioinformatics. , 2002, BMJ.

[15]  J. Manson,et al.  Calcium plus vitamin D supplementation and the risk of fractures. , 2006, The New England journal of medicine.

[16]  D L Patrick,et al.  Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). , 1994, American journal of preventive medicine.

[17]  E. Barrett-Connor,et al.  Osteoporosis and Fracture Risk in Women of Different Ethnic Groups , 2004, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[18]  Bess Dawson-Hughes,et al.  Effect of Vitamin D on falls: a meta-analysis. , 2004, JAMA.

[19]  JoAnn E. Manson,et al.  Design of the Women's Health Initiative clinical trial and observational study. The Women's Health Initiative Study Group. , 1998, Controlled clinical trials.

[20]  M. Holick.  High prevalence of vitamin D inadequacy and implications for health. , 2006, Mayo Clinic proceedings.

[21]  J. Cauley,et al.  Depression, falls, and risk of fracture in older women. Study of Osteoporotic Fractures Research Group. , 1999, Archives of internal medicine.

[22]  S. Cummings,et al.  Nulliparity and Fracture Risk in Older Women: The Study of Osteoporotic Fractures , 2003, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[23]  R. Recker,et al.  Relevance of the genes for bone mass variation to susceptibility to osteoporotic fractures and its implications to gene search for complex human diseases , 2002, Genetic epidemiology.

[24]  J. Cauley,et al.  Nontraumatic fracture risk with diabetes mellitus and impaired fasting glucose in older white and black adults: the health, aging, and body composition study. , 2005, Archives of internal medicine.

[25]  A. LaCroix,et al.  Effects of estrogen plus progestin on risk of fracture and bone mineral density: the Women's Health Initiative randomized trial. , 2003, JAMA.

[26]  S. Cummings,et al.  Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group. , 1995, The New England journal of medicine.

[27]  M. Nevitt,et al.  Aspirin and NSAID use in older women: Effect on bone mineral density and fracture risk , 1996, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[28]  Greg Maislin,et al.  Risk Factors for Hip Fracture in Black Women , 1994 .

[29]  A. LaCroix,et al.  Validity of self-report for fractures among a multiethnic cohort of postmenopausal women: results from the Women's Health Initiative observational study and clinical trials , 2004, Menopause.

[30]  S. Cummings,et al.  BMD at Multiple Sites and Risk of Fracture of Multiple Types: Long‐Term Results From the Study of Osteoporotic Fractures , 2003, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[31]  J. Goodwin,et al.  Impact of selected medical conditions on self-reported lower-extremity function in Mexican-American elderly. , 1998, Ethnicity & disease.

[32]  K. Ensrud,et al.  Body size and risk for clinical fractures in older women. Study of Osteoporotic Fractures Research Group. , 2000, Annals of internal medicine.

[33]  J. Brody,et al.  Race and sex differences in mortality following fracture of the hip. , 1992, American journal of public health.

[34]  C. Cooper,et al.  Perspective how many women have osteoporosis? , 1992, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[35]  G. Ostir,et al.  Diabetes mellitus as a risk factor for hip fracture in mexican american older adults. , 2002, The journals of gerontology. Series A, Biological sciences and medical sciences.

[36]  K. Bailey,et al.  Race and sex differences in hip fracture incidence. , 1984, American journal of public health.

[37]  T. Harris,et al.  Proximal femur bone mineral levels of US adults , 2005, Osteoporosis International.

[38]  M. Cogswell,et al.  Hypovitaminosis D prevalence and determinants among African American and white women of reproductive age: third National Health and Nutrition Examination Survey, 1988-1994. , 2002, The American journal of clinical nutrition.

[39]  Samprit Banerjee,et al.  Racial disparities in the receipt of osteoporosis related healthcare among community-dwelling older women with arthritis and previous fracture. , 2005, The Journal of rheumatology.

[40]  S. Cummings,et al.  Effects of Thiazide Diuretic Therapy on Bone Mass, Fractures, and Falls , 1993, Annals of Internal Medicine.

[41]  D. Bauer,et al.  β‐Blocker Use, BMD, and Fractures in the Study of Osteoporotic Fractures , 2004, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[42]  S. Cummings,et al.  Bone mineral density and the risk of incident nonspinal fractures in black and white women. , 2005, JAMA.

[43]  E. Fisher,et al.  RACIAL DIFFERENCES IN FRACTURE RISK , 1994, Epidemiology.

[44]  J L Kelsey,et al.  Risk factors for hip fracture in black women. The Northeast Hip Fracture Study Group. , 1994, The New England journal of medicine.

[45]  S. Cummings,et al.  Epidemiology and outcomes of osteoporotic fractures , 2002, The Lancet.

[46]  A. LaCroix,et al.  Effects of Conjugated Equine Estrogen on Risk of Fractures and BMD in Postmenopausal Women With Hysterectomy: Results From the Women's Health Initiative Randomized Trial , 2006, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[47]  K. Kodama,et al.  Risk Factors for Hip Fracture in a Japanese Cohort , 1997, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[48]  L. Melton,et al.  Medical Expenditures for the Treatment of Osteoporotic Fractures in the United States in 1995: Report from the National Osteoporosis Foundation , 1997, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[49]  P. J. Bowman,et al.  Central nervous system active medications and risk for fractures in older women. , 2003, Archives of internal medicine.

[50]  S. Cummings,et al.  Very low rates of hip fracture in Beijing, People's Republic of China the Beijing Osteoporosis Project. , 1996, American journal of epidemiology.

[51]  P. J. Bowman,et al.  Central Nervous System–Active Medications and Risk for Falls in Older Women , 2002, Journal of the American Geriatrics Society.

[52]  Jacques P. Brown,et al.  The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women , 2007, Osteoporosis International.

[53]  M. Mezey,et al.  Differences in outcome between black and white elderly hip fracture patients. , 1987, Journal of chronic diseases.