Height loss in elderly individuals is associated with the risk of hip fracture, show two independent studies published in the Journal of Bone and Mineral Research.

“A connection between height loss and hip fractures was known historically,” says Marian Hannan, lead researcher of the first study. However, no formal studies had been performed to assess the value of this marker to predict hip fracture risk.

Hannan and her colleagues analyzed data from a cohort of 3,081 men and women enrolled in the Framingham Heart Study who had never had a hip fracture between 1948, the date of study enrolment, and 1974–1975. Height loss was calculated over this 24-year period, at which point participants were 66 years old on average. The occurrence of fractures was measured over a subsequent mean follow-up period of 17 years. In men (but not in women), the hazard ratio (HR) for hip fracture was 1.4 (95% CI 1.00–1.99) for every 2.54 cm of height loss, considered as a continuous variable. The researchers also examined the association between fracture risk and recent height loss, using data collected during the 17-year follow-up period. Height was measured biannually and the occurrence of hip fractures within 2 years after a height measurement was considered. In this elderly population, the risk of hip fracture was associated with recent height loss in both men (HR 1.5, 95% CI 1.14–2.09) and women (HR 1.21, 95% CI 1.03–1.42).

In the second study, Teresa Hillier and colleagues independently investigated the risks of hip fracture, other nonspinal fractures and mortality in a cohort of 3,124 women aged ≥65 years who enrolled in the Study of Osteoporotic Fractures. The participants' height change within a period of 15 years was calculated, and the three study outcomes were recorded over the subsequent 5 years, on average. The risks of hip fracture, nonspinal fracture and mortality were increased in women who lost >5 cm in height compared with women with ≤5 cm of height loss (HR 1.50, 95% CI 1.06–2.12; HR 1.48, 95% CI 1.20–1.83; HR 1.45, 95% CI 1.21–1.73, respectively). These increased risks were independent of incident vertebral fractures and BMD.

“Often a hip fracture is our first notification that something is wrong,” comments Hannan. In this context, noninvasive fracture risk markers that can be assessed at each medical visit are valuable. “If a decline in height occurs, it should signal a conversation with the health-care provider about the possibility or likelihood of bone loss and the possible need for evaluation of bone health now and/or across time,” she concludes.