Vertebral Fractures Assessed by Dual-Energy X-Ray Absorptiometry and All-Cause Mortality:The Tromsø Study, 2007-2020

• Published in: American Journal of Epidemiology
• Main Authors: Johansson, Jonas, Emaus, Nina, Geelhoed, Bastiaan, Sagelv, Edvard, Morseth, Bente
• Format: Article in Journal/Newspaper
• Language: English
• Published: 2023
• Subjects: all-cause mortality; dual-energy x-ray absorptiometry; older adults; vertebral fractures; Tromsø
• Online Access: https://hdl.handle.net/11370/cf2a3899-a1c2-40dd-9e13-e61d46d3bc6b; https://research.rug.nl/en/publications/cf2a3899-a1c2-40dd-9e13-e61d46d3bc6b; https://doi.org/10.1093/aje/kwac161; https://pure.rug.nl/ws/files/845132890/Vertebral_Fractures_Assessed_by_Dual-Energy_X-Ray_Absorptiometry_and_All-Cause_Mortality_The_Troms_Study_2007_2020.pdf; http://www.scopus.com/inward/record.url?scp=85145954624&partnerID=8YFLogxK

Vertebral fractures have been associated with increased mortality, but findings are inconclusive, and many vertebral fractures avoid clinical attention. We investigated this association in a general population of 2,476 older adults aged =55 years from Tromsø, Norway, who were followed over 2007-2020, using dual-energy x-ray absorptiometry (DXA) at baseline to evaluate vertebral fractures (mild, moderate, or severe). We used multiple Cox regression models to estimate hazard ratios (HRs) for all-cause mortality, adjusted for age, sex, body mass index, education, smoking, alcohol intake, cardiovascular disease, and respiratory disease. Mean follow-up in the cohort was 11.2 (standard deviation, 2.7) years; 341 participants (13.8%) had =1 vertebral fracture at baseline, and 636 participants (25.7%) died between baseline and follow-up. Full-adjustment models showed a nonsignificant association between vertebral fracture status (yes/no) and mortality. Participants with =3 vertebral fractures (HR = 2.43, 95% confidence interval: 1.57, 3.78) or =1 severe vertebral fracture (HR = 1.65, 95% confidence interval: 1.26, 2.15) had increased mortality compared with those with no vertebral fractures. Dual-energy x-ray absorptiometry-based screening could be a potent and feasible tool in detecting vertebral fractures that are often clinically silent yet independently associated with premature death. Our data indicated that detailed vertebral assessment could be warranted for a more accurate survival estimation.