Among postmenopausal women, the risk of hip fractures increases steeply with age and is seven times higher in 70-year olds than in 50- year olds, according to a study in this week's PLoS Medicine.
The study also found that in women aged 50-54 years (i.e. around the time of menopause), although hip fractures are rare, the risk of a fracture in postmenopausal women is twice that in premenopausal women. Women who had an early menopause before age 45 had a slightly increased risk of hip fracture. However, any effect of early menopause on the risk of hip fracture was small compared to the effect of age itself, and the slightly increased risk of fractures in early menopause may have been due to other factors that could not be fully accounted for in the study.
The study, by Emily Banks (The Australian National University, Acton, Australia) and colleagues, followed women who were participating in the well-known Million Women Study (www.millionwomenstudy.org), a national study of women's health involving 1.3 million UK women aged 50 and over. At enrollment and three years later, the study participants provided information about their menopausal status and other health and lifestyle factors likely to affect their fracture risk.
"Our findings show that age is far more important than factors relating to menopause in determining the risk of hip fracture," say Banks and colleagues. "Hence, clinical decisions around hip fracture prevention should be based on age, and age-related factors, such as frailty, low body-mass-index, sensory impairment, and comorbidity, rather than on age at menopause."
Funding: The Million Women Study is funded by Cancer Research UK, the NHS Breast Screening Programme, and the Medical Research Council. EB is supported by the Australian National Health and Medical Research Council. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing Interests: The authors have declared that no competing interests exist.
Citation: Banks E, Reeves GK, Beral V, Balkwill A, Liu B, et al. (2009) Hip Fracture Incidence in Relation to Age, Menopausal Status, and Age at Menopause: Prospective Analysis. PLoS Med 6(11): e1000181. doi:10.1371/journal.pmed.1000181
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Australian National University
National Centre for Epidemiology and Population Health