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Genetic liability to fractures in the elderly
Karl Michaëlsson1, Håkan Melhus, Helene Ferm
1Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden. karl.michaelsson@surgsci.uu.se
Archives of Internal Medicine
|September 15, 2005
Summary
Genetic factors influence fracture risk, particularly for hip fractures in younger elderly individuals. Prevention strategies should consider age and fracture type, emphasizing lifestyle interventions for the oldest.
Area of Science:
- Gerontology
- Orthopedics
- Genetics
Background:
- The genetic contribution to osteoporotic fractures remains incompletely understood.
- Large-scale twin studies are crucial for assessing genetic liability across different fracture types and age groups.
Purpose of the Study:
- To evaluate the genetic liability to fracture occurrence in the elderly using a large Swedish twin cohort.
- To determine how genetic factors influence the risk of various fracture types at different ages.
Main Methods:
- A cohort of 33,432 Swedish twins (born 1896-1944) was analyzed.
- Fracture data (any fracture, osteoporotic fracture, hip fracture) after age 50 were identified through the Swedish Inpatient Registry and telephone interviews.
Main Results:
- Genetic variation in fracture liability differs significantly by fracture type and age, explaining less than 20% of overall variance.
- Heritability for osteoporotic fractures was 0.27, and for hip fractures, it was 0.48.
- Heritability for hip fractures was highest in younger age groups (e.g., 0.68 before age 69) and decreased significantly in older individuals.
Conclusions:
- The influence of genetic factors on fracture propensity is site- and age-dependent.
- Further research into genetic and environmental factors is recommended for younger elderly individuals with hip fractures.
- Lifestyle interventions are paramount for fracture prevention in the oldest elderly population.