Association of Race and Other Potential Risk Factors with Nonvertebral Fractures in Community-dwelling Elderly Women

This study determined potential associations of sociodemographic, lifestyle, health, and drug use factors known to affect bone metabolism with incident nonvertebral fractures. The baseline sample consisted of 2,590 female, nonproxy subjects from the Duke Established Populations for Epidemiologic Studies of the Elderly, which focuses on five adjacent counties in the Piedmont area of North Carolina. Information about potential risk factors was collected during a baseline in-home interview during 1986-1987. Subsequent nonvertebral fractures were reported at follow-up interviews during the annual follow-up periods (1988-1993). The authors used multivariate analyses in which weighted data were adjusted for sampling design. After controlling for other potential confounding sociodemographic, lifestyle, health, and drug use factors, they found that African American race (adjusted odds ratio (OR) = 0.43, 95% confidence interval (Cl) 0.31-0.58), age (adjusted OR = 1.04, 95% Cl 1.01-1.06), alcohol consumption (adjusted OR = 1.61, 95% Cl 1.01-2.57), being underweight (adjusted OR = 1.63, 95% Cl 1.13-2.34), cognitive impairment (adjusted OR = 1.67, 95% Cl 1.12-2.48), impaired mobility (adjusted OR = 1.15, 95% Cl 1.03-1.29), and phenytoin use (adjusted OR % 2.93, 95% Cl 1.04-8.30) were associated with first fracture occurrence. Similar findings were observed for nonhip, nonvertebral fractures. African Americans were less likely than Whites to have nonvertebral fractures, and these differences were not related to lifestyle or health factors examined in this study. Am J Epidemiol 1999; 149:1002–9.