New Proposals for Avoiding Hip Fractures in the Elderly

A broken hip is a serious condition for older patients.  As many as 15% to 25% of those over 65 who sustain a fractured hip die within a year.  So suggestions about avoiding such a fracture abound: treating osteoporosis, increasing physical activity, improving balance, and fall-proofing homes and residences are the main measures to be taken.   Now two new proposals have recently been reported.   

The first involves a possible role for increased dietary protein in 75-year-olds;  it’s reported in the journal Osteoporosis International. The Framingham Osteoporosis Study enrolled 576 women and 370 men, who completed food frequency questionnaires that allowed them to be divided into 4 groups, or quartiles, based on their daily protein intake.  Those who were in the lowest 25% of protein intake had roughly 50% more hip fractures than those eating greater amounts of protein.  The researchers reckon that at least 46 grams of protein daily for women, and 56 grams daily for men is the critical amount to be exceeded, if you want to avoid a hip fracture.  The theory is that more than enough protein helps build leg muscles that will prevent falls. . .  

The second study, published in the Journal of Bone and Joint Surgery, dealt with the risk of the need for ‘revision’ (i.e. repeating the whole procedure) after total hip replacement.  Over 2,300 patients who had revision procedures were studied, and compared with an equal number who had not required a revision.  Apparently statins (yes, again!) substantially reduce the risk of revision.  Now this isn’t the same as the risk of hip fracture, but it’s possible that the underlying mechanism is the same.  The authors of the study say that “statin use was associated with a reduced risk of revision due to deep infection, aseptic loosening, dislocation, and periprosthetic fracture”.  We know that statins have an anti-inflammatory effect, but it’s quite possible they encourage bone formation, an effect that would be helpful in threatened trauma. 

(Maybe this second one is a stretch, but I like statins and wouldn’t be surprised if they also helped build bone to reduce fracture risk.  But I don’t suggest everyone over 65 should be taking statins ‘just in case’.)