Skip to main content

Advertisement

SpringerLink
Log in

Risk factors for foot fracture among individuals aged 45 years and older

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

A case-control study undertaken among members of five Northern California Kaiser Permanente medical centers sought to identify risk factors for foot fractures among persons aged 45 years and older. Foot fracture cases (n=920) and frequency matched controls (n=2366) were interviewed between October 1996 and May 2001 using a standardized questionnaire. Foot fractures occurred most often while walking or climbing stairs. While 60% of foot fractures resulted from falls, 20% were attributed to other causes, such as hitting the foot or tripping on sidewalks and curbs. Having a self-reported history of physician-diagnosed diabetes [adjusted odds ratio (OR)=1.45, 95% confidence interval (CI)=1.10–1.91] or cataracts (OR=1.40, 95% CI=1.07–1.83), having a self-reported foot problem (OR=1.38, 95% CI=1.06–1.78 for two or more foot problem versus no foot problems), having difficulty walking in minimum light (OR=1.86, 95% CI=1.14–3.05) and having had a prior fracture (OR=1.20, 95% CI=1.05–1.37) were associated with increased risk. Putative protective factors for osteoporotic fractures, such as menopausal hormone therapy use, thiazide or water pill use, high calcium intake, and high body mass index were not associated with foot fracture risk. These findings suggest that risk factors for foot fractures among older people differ in part from risk factors for other fracture sites generally considered to be osteoporotic, such as the hip, vertebrae, and forearm.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Seeley D, Browner W, Nevitt M, Genant H, Scott J, Cummings S (1991) Which fractures are associated with low appendicular bone mass in elderly women? Ann Int Med 115:837–842

    CAS  PubMed  Google Scholar 

  2. Turchin DC, Schemitsch EH, McKee MD, Waddell JP (1999) Do foot injuries significantly affect the functional outcome of multiply injured patients? J Orthop Trauma 13:1–4

    Article  CAS  PubMed  Google Scholar 

  3. Tran T, Thordarson D (2002) Functional outcome of multiply injured patients with associated foot injury. Foot Ankle Int 23:340–343

    PubMed  Google Scholar 

  4. Hasselman CT, Vogt MT, Stone KL, Cauley JA, Conti SF (2003) Foot and ankle fractures in elderly white women: incidence and risk factors. J Bone Joint Surg [Am] 85A:820–824

    Google Scholar 

  5. Honkanen R, Kroger H, Tuppurainen M, Alhava E, Saarikoski S (1995) Fractures and low axial bone density in perimenopausal women. J Clin Epidemiol 48:881–888

    Google Scholar 

  6. Schwartz AV, Sellmeyer DE, Ensrud KE, Cauley JA, Tabor HK, Schreiner PJ, Jamal SA, Black DM, Cummings SR (2001) Older women with diabetes have an increased risk of fracture: a prospective study. J Clin Endocrinol Metab 86:32–38

    Google Scholar 

  7. Seeley D, Kelsey J, Jergas M, Nevitt M (1996) Predictors of ankle and foot fractures in older women. J Bone Miner Res 11:1347–1355

    CAS  PubMed  Google Scholar 

  8. Ivers RQ. Norton R, Cumming R, Butler M, Campbell AJ (2000) Visual impairment and risk of hip fracture. Am J Epidemiol 152:633–639

    Article  CAS  PubMed  Google Scholar 

  9. Abdelhafiz A, Austin C (2003) Visual factors should be assessed in older people presenting with falls or hip fracture. Age Ageing 32:26–30

    Article  Google Scholar 

  10. Keegan THM, Kelsey J, Sidney S, Quesenberry Jr C (2002) Foot problems as risk factors of fractures. Am J Epidemiol 155:926–931

    Article  PubMed  Google Scholar 

  11. Keegan THM, Gopalakrishnun G, Sidney S, Quesenberry Jr, CP, Kelsey J (2003) Hormone replacement therapy and risk for foot, distal forearm, proximal humerus, and pelvis fracture. Osteoporos Int 14:469–475

    Article  CAS  PubMed  Google Scholar 

  12. Sidney S, Jacobs DR Jr, Haskell W, Armstrong MA, Dimicco A, Oberman A et al. (1991) Comparison of two methods of assessing physical activity in the coronary artery risk development in young adults (CARDIA) Study. Am J Epidemiol 133:1231–1245

    CAS  PubMed  Google Scholar 

  13. Ainsworth BE (2000) Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 32:S498--S504

    CAS  PubMed  Google Scholar 

  14. Gomez SL (2002) Methodological issues regarding race, ethnicity and birthplace in epidemiologic research. PhD dissertation, Stanford University

  15. Snellman K (2001) Sports injuries in floorball: a prospective one-year follow-up study. Int J Sports Med 22:501–506

    Article  Google Scholar 

  16. Islam SS, Biswas RS, Nambiar AM, Syamlal G, Velilla AM, Ducatman AM, Doyle EJ (2001) Incidence and risk of work-related fracture injuries: experience of a state-managed workers’ compensation system. J Occup Environ Med 43:140–146

    Article  CAS  PubMed  Google Scholar 

  17. Elgafy H (2000) Fractures of the talus: experience of two level 1 trauma centers. Foot Ankle Int 21:1023–1029

    CAS  PubMed  Google Scholar 

  18. Renstrom AF (1993) Mechanisms, diagnosis, and treatment of running injuries. Instr Course Let 42:225–234

    CAS  Google Scholar 

  19. Griffin MR, Ray WA, Fought RL, Melton LJ III (1992) Black-white differences in fracture risk. Am J Epidemiol 136:1378–1385

    CAS  Google Scholar 

  20. Wallace C, Reiber G, LeMaster J, Smith D, Sullivan K, Hayes S et al. (2002) Incidence of falls, risk factors for falls and fall-related fractures in individuals with diabetes and a prior foot ulcer. Diabetes Care 25:1983–1986

    PubMed  Google Scholar 

  21. Visser M, Pluijm SM, Stel VS, Bosscher RJ, Deeg DJ, Longitudinal Aging Study Amsterdam (2002) Physical activity as a determinant of change in mobility performance: the Longitudinal Aging Study Amsterdam. J Am Geriatr Soc 50:1774–1781

    Article  PubMed  Google Scholar 

  22. LaCroix AZ, Guralnik JM, Berkman LF, Wallace RB, Satterfield S (1993) Maintaining mobility in late life II. Smoking, alcohol consumption, physical activity, and body mass index. Am J Epidemiol 137:858–869

    CAS  PubMed  Google Scholar 

  23. Gerdhem P, Ringsberg KA, Magnusson H, Obrant KJ, Akesson K (2003) Bone mass cannot be predicted by estimations of frailty in elderly ambulatory women. Gerontology 49:168–172

    Article  PubMed  Google Scholar 

  24. Wells G, Tugwell P, Shea B, Guyatt G, Peterson J, Zytaruk N et al. (2002) Meta-analysis of the efficacy of hrmone replacement therapy in treating and preventing osteoporosis in postmenopausal women. Endocr Rev 23:529–539

    Article  CAS  PubMed  Google Scholar 

  25. Ray WA, Griffin M, Downey W, Melton III LJ (1989) Long term use of thiazide diuretics and risk of hip fracture. Lancet 1:687–690

    Article  CAS  PubMed  Google Scholar 

  26. Stewart A, Jackson R, Ford M, Beaglehole R (1987) Underestimation of relative weight by use of self-reported height and weight. Am J Epidemiol 125:122–126

    CAS  Google Scholar 

  27. Kuskowska-Wolk, A, Karlsson P, Stolt M, Rossner S (1989) The predictive validity of body mass index based on self-reported weight and height. Int J Obes 13:441–453

    CAS  PubMed  Google Scholar 

  28. Niedhammer I, Bugel I, Bonenfant S, Goldberg M, Leclerc A (2000) Validity of self-reported weight and height in the French GAZEL cohort. Int J Obes Relat Metab Disord 24:1111–1118

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. UCLA Division of Geriatrics, Suite 2339, 10945 Le Conte Avenue, Box 951687, Los Angeles, CA 90095-1687, USA

    Crystal M. Luetters

  2. Division of Epidemiology, Stanford University School of Medicine, Stanford, Calif., USA

    Theresa H. M. Keegan, Mila Prill & Jennifer Kelsey

  3. Division of Research, Kaiser Permanente Medical Care Program, Oakland, Calif., USA

    Stephen Sidney, Charles P. Quesenberry & Barbara Sternfeld

Authors
  1. Crystal M. Luetters
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Theresa H. M. Keegan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Stephen Sidney
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Charles P. Quesenberry
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mila Prill
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Barbara Sternfeld
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jennifer Kelsey
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Crystal M. Luetters.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Luetters, C.M., Keegan, T.H.M., Sidney, S. et al. Risk factors for foot fracture among individuals aged 45 years and older. Osteoporos Int 15, 957–963 (2004). https://doi.org/10.1007/s00198-004-1625-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-004-1625-2

Keywords

Search

Navigation