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APOE 4 and Hip Fracture Risk in a Community‐Based Study of Older Adults
Author(s) -
Johnston Janet M.,
Cauley Jane A.,
Ganguli Mary
Publication year - 1999
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1999.tb07436.x
Subject(s) - medicine , hip fracture , dementia , apolipoprotein e , prospective cohort study , gerontology , risk factor , physical therapy , demography , osteoporosis , disease , sociology
OBJECTIVES: To investigate whether the APOE 4 allele was associated with increased risk of hip fracture in an older community‐based sample and whether such an increased risk was independent of dementia and history of falling. DESIGN: Case‐control study nested within a prospective community study. SETTING: The Monongahela Valley Independent Elders Survey (MoVIES), an ongoing prospective community study of older adults in southwestern Pennsylvania. PARTICIPANTS: A total of 899 MoVIES participants (63.9% women; mean age, 76.2 years, SD = 4.9 years), who provided both information on hip fractures and blood samples for genotyping. MEASUREMENTS: Interview questions regarding hip fractures and falls, polymerase chain reaction to determine APOE genotype, and clinical assessment using a standardized protocol to determine the presence or absence of dementia. RESULTS: Twenty‐five subjects reported having hip fractures in the year preceding screening interviews. Subjects with one or two APOE 4 alleles were twice as likely as subjects without an APOE 4 allele to report hip fractures (age‐adjusted OR = 2.1,95% CI: 0.9–4.7). Based on multivariate analysis, subjects with a history of falling were more likely to report hip fractures (OR = 4.7, 95% CI: 2.1–10.8). After adjusting for history of falls and diagnosis of dementia, subjects with an APOE 4 allele were still twice as likely to report hip fractures (adjusted OR = 2.1, 95% CI: 0.9 – 4.7). CONCLUSIONS: The APOE 4 allele appears to be a risk factor for hip fracture, independent of the effect of dementia and falling. Theoretically, this may be mediated by alterations in vitamin K metabolism. Caution should be used in interpreting these results, because the 95% confidence intervals for the odds ratios include 1. J Am Geriatr Soc 47:1342–1345,1999.