Abdominal aortic calcification is associated with hip fracture in the elderly

Hip fracture, the most serious fragility fracture in elderly osteoporotic patients, is critical to address as it decreases levels of activities of daily living, worsens life expectancy and increases risk of requiring long-term care. Many patients with hip fracture are unaware of their risk at the time of fracture and therefore do not use osteoporosis medications. Thus, a tool is needed to raise patient awareness of hip fracture risk. Here we enrolled 1395 hip fracture cases and 1075 non-hip fracture controls and evaluated their respective abdominal aortic calcification semiquantitatively using lumbar spine lateral X-ray images. That analysis revealed that the degree of abdominal aorta calcification (AAC) seen on lateral lumbar spine X-ray images, as indicated by a score of 5, was significantly and positively correlated with hip fracture occurrence. In particular, we show that calcification of the wall of the abdominal aorta at the level of the fourth lumbar vertebra correlated with hip fracture development. Lower back pain is a common complaint among the elderly, often prompting patients to undergo lumbar spine radiography. Thus, AAC score could serve as a potential surrogate marker to identify patients at potential risk of hip fracture as a means of encouraging them to take osteoporosis medications.