White matter lesions and the risk of incident hip fracture in older persons

Results from the Progetto Veneto Anziani study

Maria Chiara Corti, Giovannella Baggio, Leonardo Sartori, Gianmaria Barbato, Enzo Manzato, Estella Musacchio, Luigi Ferrucci, Giulia Cardinali, Daniele Donato, Lenore J. Launer, Sabina Zambon, Gaetano Crepaldi, Jack M. Guralnik

Research output: Contribution to journalArticle

Abstract

Background: White matter lesions (WMLs) are associated with hypertension, an increased risk of falling, and impaired physical and cognitive performance that may affect the mechanical effect of falls. Methods: We hypothesized that WMLs are a risk factor for hip fracture (HF). We studied a sample of 820 community-dwelling Italian persons 65 years and older from the cohort of the Progetto Veneto Anziani Study who underwent brain magnetic resonance imaging at baseline. Subjects were classified as having no lesions, focal lesions, or diffuse WMLs. Results: Compared with those with no lesions, participants with diffuse WMLs were older, reported more falls, and had worse physical and cognitive performance, all factors implicated in the causal pathway to HF. During 9 years of follow-up, 51 HFs occurred. Hip fracture risk associated with diffuse WMLs markedly differed between participants younger than 80 years vs those 80 years and older. After adjustment among participants younger than 80 years, diffuse WMLs compared with no lesions were associated with a 2.7-fold (95% confidence interval, 1.1-7.1) increase in the risk of HF. Focal lesions were not statistically significantly associated with an increased risk of HF in the same age group (hazard ratio, 2.0; 95% confidence interval, 0.6-7.6). No associations between diffuse WMLs, focal lesions, and HF were evident among participants 80 years and older, possibly because of the limited sample size. Conclusions: White matter lesions represent an independent risk factor for HF in persons younger than 80 years. Older persons with diffuse WMLs should be considered candidates for multifactorial interventions aimed at reducing the risk of falling and fractures.

Original languageEnglish (US)
Pages (from-to)1745-1751
Number of pages7
JournalArchives of Internal Medicine
Volume167
Issue number16
DOIs
StatePublished - Oct 9 2007
Externally publishedYes

Fingerprint

Hip Fractures
Accidental Falls
Confidence Intervals
Independent Living
White Matter
Sample Size
Age Groups
Magnetic Resonance Imaging
Hypertension
Brain

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Corti, M. C., Baggio, G., Sartori, L., Barbato, G., Manzato, E., Musacchio, E., ... Guralnik, J. M. (2007). White matter lesions and the risk of incident hip fracture in older persons: Results from the Progetto Veneto Anziani study. Archives of Internal Medicine, 167(16), 1745-1751. https://doi.org/10.1001/archinte.167.16.1745

White matter lesions and the risk of incident hip fracture in older persons : Results from the Progetto Veneto Anziani study. / Corti, Maria Chiara; Baggio, Giovannella; Sartori, Leonardo; Barbato, Gianmaria; Manzato, Enzo; Musacchio, Estella; Ferrucci, Luigi; Cardinali, Giulia; Donato, Daniele; Launer, Lenore J.; Zambon, Sabina; Crepaldi, Gaetano; Guralnik, Jack M.

In: Archives of Internal Medicine, Vol. 167, No. 16, 09.10.2007, p. 1745-1751.

Research output: Contribution to journalArticle

Corti, MC, Baggio, G, Sartori, L, Barbato, G, Manzato, E, Musacchio, E, Ferrucci, L, Cardinali, G, Donato, D, Launer, LJ, Zambon, S, Crepaldi, G & Guralnik, JM 2007, 'White matter lesions and the risk of incident hip fracture in older persons: Results from the Progetto Veneto Anziani study', Archives of Internal Medicine, vol. 167, no. 16, pp. 1745-1751. https://doi.org/10.1001/archinte.167.16.1745
Corti, Maria Chiara ; Baggio, Giovannella ; Sartori, Leonardo ; Barbato, Gianmaria ; Manzato, Enzo ; Musacchio, Estella ; Ferrucci, Luigi ; Cardinali, Giulia ; Donato, Daniele ; Launer, Lenore J. ; Zambon, Sabina ; Crepaldi, Gaetano ; Guralnik, Jack M. / White matter lesions and the risk of incident hip fracture in older persons : Results from the Progetto Veneto Anziani study. In: Archives of Internal Medicine. 2007 ; Vol. 167, No. 16. pp. 1745-1751.
@article{8f9c2fbe214740e196c1c4b34ea3f29b,
title = "White matter lesions and the risk of incident hip fracture in older persons: Results from the Progetto Veneto Anziani study",
abstract = "Background: White matter lesions (WMLs) are associated with hypertension, an increased risk of falling, and impaired physical and cognitive performance that may affect the mechanical effect of falls. Methods: We hypothesized that WMLs are a risk factor for hip fracture (HF). We studied a sample of 820 community-dwelling Italian persons 65 years and older from the cohort of the Progetto Veneto Anziani Study who underwent brain magnetic resonance imaging at baseline. Subjects were classified as having no lesions, focal lesions, or diffuse WMLs. Results: Compared with those with no lesions, participants with diffuse WMLs were older, reported more falls, and had worse physical and cognitive performance, all factors implicated in the causal pathway to HF. During 9 years of follow-up, 51 HFs occurred. Hip fracture risk associated with diffuse WMLs markedly differed between participants younger than 80 years vs those 80 years and older. After adjustment among participants younger than 80 years, diffuse WMLs compared with no lesions were associated with a 2.7-fold (95{\%} confidence interval, 1.1-7.1) increase in the risk of HF. Focal lesions were not statistically significantly associated with an increased risk of HF in the same age group (hazard ratio, 2.0; 95{\%} confidence interval, 0.6-7.6). No associations between diffuse WMLs, focal lesions, and HF were evident among participants 80 years and older, possibly because of the limited sample size. Conclusions: White matter lesions represent an independent risk factor for HF in persons younger than 80 years. Older persons with diffuse WMLs should be considered candidates for multifactorial interventions aimed at reducing the risk of falling and fractures.",
author = "Corti, {Maria Chiara} and Giovannella Baggio and Leonardo Sartori and Gianmaria Barbato and Enzo Manzato and Estella Musacchio and Luigi Ferrucci and Giulia Cardinali and Daniele Donato and Launer, {Lenore J.} and Sabina Zambon and Gaetano Crepaldi and Guralnik, {Jack M.}",
year = "2007",
month = "10",
day = "9",
doi = "10.1001/archinte.167.16.1745",
language = "English (US)",
volume = "167",
pages = "1745--1751",
journal = "JAMA Internal Medicine",
issn = "2168-6106",
publisher = "American Medical Association",
number = "16",

}

TY - JOUR

T1 - White matter lesions and the risk of incident hip fracture in older persons

T2 - Results from the Progetto Veneto Anziani study

AU - Corti, Maria Chiara

AU - Baggio, Giovannella

AU - Sartori, Leonardo

AU - Barbato, Gianmaria

AU - Manzato, Enzo

AU - Musacchio, Estella

AU - Ferrucci, Luigi

AU - Cardinali, Giulia

AU - Donato, Daniele

AU - Launer, Lenore J.

AU - Zambon, Sabina

AU - Crepaldi, Gaetano

AU - Guralnik, Jack M.

PY - 2007/10/9

Y1 - 2007/10/9

N2 - Background: White matter lesions (WMLs) are associated with hypertension, an increased risk of falling, and impaired physical and cognitive performance that may affect the mechanical effect of falls. Methods: We hypothesized that WMLs are a risk factor for hip fracture (HF). We studied a sample of 820 community-dwelling Italian persons 65 years and older from the cohort of the Progetto Veneto Anziani Study who underwent brain magnetic resonance imaging at baseline. Subjects were classified as having no lesions, focal lesions, or diffuse WMLs. Results: Compared with those with no lesions, participants with diffuse WMLs were older, reported more falls, and had worse physical and cognitive performance, all factors implicated in the causal pathway to HF. During 9 years of follow-up, 51 HFs occurred. Hip fracture risk associated with diffuse WMLs markedly differed between participants younger than 80 years vs those 80 years and older. After adjustment among participants younger than 80 years, diffuse WMLs compared with no lesions were associated with a 2.7-fold (95% confidence interval, 1.1-7.1) increase in the risk of HF. Focal lesions were not statistically significantly associated with an increased risk of HF in the same age group (hazard ratio, 2.0; 95% confidence interval, 0.6-7.6). No associations between diffuse WMLs, focal lesions, and HF were evident among participants 80 years and older, possibly because of the limited sample size. Conclusions: White matter lesions represent an independent risk factor for HF in persons younger than 80 years. Older persons with diffuse WMLs should be considered candidates for multifactorial interventions aimed at reducing the risk of falling and fractures.

AB - Background: White matter lesions (WMLs) are associated with hypertension, an increased risk of falling, and impaired physical and cognitive performance that may affect the mechanical effect of falls. Methods: We hypothesized that WMLs are a risk factor for hip fracture (HF). We studied a sample of 820 community-dwelling Italian persons 65 years and older from the cohort of the Progetto Veneto Anziani Study who underwent brain magnetic resonance imaging at baseline. Subjects were classified as having no lesions, focal lesions, or diffuse WMLs. Results: Compared with those with no lesions, participants with diffuse WMLs were older, reported more falls, and had worse physical and cognitive performance, all factors implicated in the causal pathway to HF. During 9 years of follow-up, 51 HFs occurred. Hip fracture risk associated with diffuse WMLs markedly differed between participants younger than 80 years vs those 80 years and older. After adjustment among participants younger than 80 years, diffuse WMLs compared with no lesions were associated with a 2.7-fold (95% confidence interval, 1.1-7.1) increase in the risk of HF. Focal lesions were not statistically significantly associated with an increased risk of HF in the same age group (hazard ratio, 2.0; 95% confidence interval, 0.6-7.6). No associations between diffuse WMLs, focal lesions, and HF were evident among participants 80 years and older, possibly because of the limited sample size. Conclusions: White matter lesions represent an independent risk factor for HF in persons younger than 80 years. Older persons with diffuse WMLs should be considered candidates for multifactorial interventions aimed at reducing the risk of falling and fractures.

UR - http://www.scopus.com/inward/record.url?scp=34548630609&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34548630609&partnerID=8YFLogxK

U2 - 10.1001/archinte.167.16.1745

DO - 10.1001/archinte.167.16.1745

M3 - Article

VL - 167

SP - 1745

EP - 1751

JO - JAMA Internal Medicine

JF - JAMA Internal Medicine

SN - 2168-6106

IS - 16

ER -