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Older Men Have Similar Refracture Risk as Women

A study shows that after sustaining an initial low-trauma fracture, older men and women have a similar and substantial risk of subsequent fracture//. The study findings were reported in the January 24/31 issue of JAMA.

Despite substantial evidence that a prior fracture results in an increased risk of subsequent fracture, less than 30 percent of postmenopausal women and less than 10 percent of men with prior fracture are treated to help lower this risk. Although some of this deficiency in treatment is due to the overall lack of awareness of osteoporosis by the public and primary caregivers, the relative importance of prior fracture in relation to subsequent fracture risk does not appear to be fully appreciated, particularly in men. There are few published long-term studies on absolute risk of refracture in women, and fewer in men.

Jacqueline R. Center, M.B.B.S., Ph.D., of the Garvan Institute of Medical Research, St. Vincent's Hospital, University of New South Wales, Sydney, Australia, and colleagues examined absolute refracture risks for a variety of osteoporotic fracture types in a group of community-dwelling men (n = 1,760) and women (n = 2,245) age 60 years or older in Australia. The participants were followed up for 16 years, from July 1989 through April 2005.

There were 905 women and 337 men with an initial fracture, of whom 253 women and 71 men experienced a subsequent fracture. Women had nearly twice the risk of refracture, while men had 3.5 times the risk of refracture. The absolute risk of subsequent fracture was similar in women and men. The increase in absolute fracture risk remained for up to 10 years, by which time 40 percent to 60 percent of surviving women and men experienced a subsequent fracture.

For women, the absolute refracture risk was equivalent to or greater than the initial fracture risk of a woman 10 years older. For example, a 60- to 69-year-old woman with an initial fracture had an absolute
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