Circumstances of clinical fracture events with advancing age in older men.

Ensrud KE, Patel S, Langsetmo L, Cawthon PM, Fink HA, Schousboe JT, Bauer DC, Cauley JA, Orwoll ES, Osteoporotic Fractures in Men (MrOS) Study. Circumstances of clinical fracture events with advancing age in older men. JBMR plus. 2025 Mar 1; 9(3):ziaf005.

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Abstract:

To characterize fracture circumstances by age at time of fracture among community-dwelling older men, we analyzed incident clinical fractures in the Osteoporotic Fractures in Men study. Participants were contacted every 4 mo to identify fractures confirmed by radiographic reports. Fractures were classified as fall- or non-fall-related and further categorized by degree of trauma: minimal (fall from = standing height), moderate (fall on stairs, steps or curb), or severe (fall from > standing height) for fall-related fractures; and minimal (eg, coughing), moderate (eg, collisions with objects during normal activity without falling), or severe (eg, motor vehicle accident) for non-fall-related fractures. Of 2351 clinical fractures in 1424 men during an average follow-up of 9.9 yr, 12.7% occurred at age < 75 yr, 15.7% at age 75-79 yr, 26.1% at age 80-84 yr, and 45.5% at age = 85 yr. A total of 1891 fractures (80.4% of all fractures) were the result of a fall. The proportion of fall-related fractures steadily rose with increasing age at time of fracture, ranging from 65.8% in men < 75 yr rising to 84.7% in men = 85 yr (  < .001). Most fall-related fractures (76.4%) were due to minimal trauma; the proportion of all fractures due to a fall with minimal trauma steadily rose with increasing age (  < .001). In contrast, approximately half of non-fall-related fractures (53.5%) were due to severe trauma. The proportion of all fractures due to severe trauma (whether fall-related or not) declined with advancing age (  < .001). In conclusion, the most frequently occurring fracture circumstance in older men was a fall from = standing height. This circumstance was increasingly common with advancing age occurring in 7 of every 10 fractures in men = 85 yr, while a fracture (fall-related or not) due to severe trauma was less common with advancing age. Findings have implications for development of fracture prevention strategies in older men.