Women with mild cognitive impairment (MCI) and dementia have a higher risk of hip fractures than women with normal cognition, a recent study found. However, not taking into account the competing risk of mortality significantly overestimates the risk of hip fracture in women in the ninth and tenth decades of life with cognitive impairment. 1,491 women (mean age 87.6 years) participating in the prospective Study of Osteoporotic Fractures (SOF) Year 20 exam were cognitively assessed and followed to ascertain vital status (deaths verified by death certificates) and hip fractures (confirmed by radiographic reports). Cognitive status was categorized as normal, MCI, or dementia, based on a standardized evaluation. Researchers found:
- During an average follow‐up of 5.6 years, 139 (9.3%) women experienced a hip fracture and 990 (66.4%) died before experiencing this outcome.
- Among women with dementia, the risk of hip fracture was 11.7% at 5 years and 18.6% at 10 years using traditional survival analysis vs 7.9% at 5 years and 8.8% at 9.8 years using a competing risk approach.
- Results were similar for women with MCI.
Diem SJ, Vo TN, Langsetmo L, Schousboe JT, Yaffe K, Ensrud KE for the Study for Osteoporotic Fractures (SOF) Research Group. Impact of competing risk of mortality on association of cognitive impairment with risk of hip fracture in older women. [Published online ahead of print May 7, 2018]. J Bone Miner Res. doi:10.1002/jbmr.3462.
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