APOE 4 and hip fracture risk in a community-based study of older adults.
Johnston-JM; Cauley-JA; Ganguli-M
J Am Geriatr Soc 1999 Nov; 47(11):1342-1345
OBJECTIVES: To investigate whether the APOE 4 allele was associated with increased risk of hip fracture in an older community-based sample and whether such an increased risk was independent of dementia and history of falling. DESIGN: Case-control study nested within a prospective community study. SETTING: The Monongahela Valley Independent Elders Survey (MoVIES), an ongoing prospective community study of older adults in southwestern Pennsylvania. PARTICIPANTS: A total of 899 MoVIES participants (63.9% women; mean age, 76.2 years, SD = 4.9 years), who provided both information on hip fractures and blood samples for genotyping. MEASUREMENTS: Interview questions regarding hip fractures and falls, polymerase chain reaction to determine APOE genotype, and clinical assessment using a standardized protocol to determine the presence or absence of dementia. RESULTS: Twenty-five subjects reported having hip fractures in the year preceding screening interviews. Subjects with one or two APOE 4 alleles were twice as likely as subjects wiithout an APOE 4 allele to report hip fractures (age- adjusted OR = 2.1, 95% CI: 0.9-4.7). Based on multivariate analysis, subjects with a history of falling were more likely to report hip fractures (OR = 4.7, 95% CI: 2.1-10.8). After adjusting for history of falls and diagnosis of dementia, subjects with an APOE 4 allele were still twice as likely to report hip fractures (adjusted OR = 2.1,95% CI: 0.9 - 4.7). CONCLUSIONS: The APOE 4 allele appears to be a risk factor for hip fracture, independent of the effect of dementia and falling. Theoretically, this may be mediated by alterations in vitamin K metabolism.
Age-factors; Age-groups; Risk-analysis; Risk-factors; Bone-structure; Genetic-factors; Humans; Statistical-analysis
Janet Johnson, PhD, NIOSH, 1095 Willowdale Road, MS/P-1133, Morgantown, WV 26505-2888
Journal of the American Geriatrics Society