Objectives: The objective of this project was to test the strength of the association between hormone-associated variables (HAV) and osteoporotic fracture in a group of older women.
Methods: The Leisure World cohort opened enrollment in 1981 and enrolled 8,877 women living in a California retirement community. Data on incident hip fractures were obtained through 2002 using self-reports and hospital discharge data. The associations of HAV (having children, history of pregnancy, hysterectomy, bilateral oophorectomy, and hormone replacement therapy (HRT)) collected at baseline with risk of hip fracture were tested using multiple regression analysis with backwards elimination starting with all HAV plus the basic variables of age, weight (kg) and history of fracture.
Results: Of the 6,223 women without prior fracture (mean age 73), 1,170 sustained a hip fracture between 1981 and 2002. 3,607 women reported they still had their uterus and at least one ovary, 3,521 women reported some use of HRT, and 4,308 reported having one or more children. In the basic model, older age (hazard ratios 1.085), and history of fracture (hazard ratios 1.429) increased risk of hip fracture while higher weight decreased risk (hazard ratio 0.983). Ever being pregnant was the only additional variable retained in the model after backwards elimination (hazard ratio 0.835) and significantly improved the original model.
Conclusions: Using hip fracture as the outcome variable, evidence was found that a simple set of questions, easily asked in dental offices including whether ever pregnant, might prove useful as a screening tool for osteoporosis.
Acknowledgement: Support was received from R01 AR 47529 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, Bethesda, MD 20892.