Almost one in six Canadians 50 or older who break their back will die within five years; for those who break their hips, that chance rises to one in four, concludes a disturbing new study.
The study, published online in the Canadian Medical Association Journal, looked at almost 2,200 men and more than 5,500 women involved as part of the ongoing Canadian Multicentre Osteoporosis Study (CaMos).
The researchers found seniors who suffered a broken hip were at three times a higher risk of dying within five years compared to seniors who didn't have a fracture. The risk of death within five years of a spinal fracture increased by almost the same amount.
"I believe this study is very important. I don't believe Canadians are aware of the consequences of osteoporosis," lead investigator George Ioannidis, a health research methodologist at McMaster University in Hamilton, told CTV News.
Researchers say it's not the broken hip or back itself that hastens death; it's the long-term effects. The study authors say hip fractures can lead to death by "inducing a progressive decline in health."
Patients with broken hips or spines are often confined to a bed for long periods to recover. That can result in a loss of muscle mass and muscle strength, and eventually, disability. The inhibited ability to exercise can often lead to, or worsen, heart disease, resulting in a fatal heart attack or stroke. In other cases, the lack of movement can lead to potentially fatal blood clots.
The study, which looked at a random sample of Canadians living in the community (as opposed to nursing homes and health-care facilities), also looked at other kinds of fractures, such as pelvic, forearm or wrist, and ribs.
They found that all types of fractures were more common in women than men, except for rib fractures. Only hip and spine fractures were associated with higher death rates.
Fractures are often a consequence of osteoporosis, a disease that affects women more often than men, often progressing unnoticed until the bone loss results in a fracture.
Osteoporosis Canada says there are about 25,000 hip fractures per year in Canada and 70 per cent are osteoporosis-related. They also note that at least 40 per cent of women older than 50 will suffer a fracture of some kind in their lifetime.
Study author Dr. Alexandra Papaioannou says while fractures are most often the result of a fall, in some seniors with osteoporosis, a spinal fracture can happen so subtly, they may not realize they've had one.
"Often the first sign is height loss. A curved back and height loss are not necessarily normal signs of aging. So after the age of 50, you should have your height checked every few years by your family doctor," she says.
In an accompanying CMAJ editorial, Dr. Karim Khan and Dr. Maureen Ashe of B.C.'s Centre for Hip Health and Mobility say steps must be taken to prevent fractures and osteoporosis.
"Best practice guidelines include the use of oral bisphosphonates, calcium and vitamin D, and strategies to prevent falls, such as balance and strength training," they write.
