Background

A history of fracture has been associated with increased risk of dementia; however, it is uncertain whether sex difference exists in the association between prior fracture and subsequent risk of incident dementia.

Objectives

To investigate whether sex modified the relationship between prior fracture and subsequent risk of dementia.

Design

Prospective cohort study.

Setting

UK Biobank.

Participants

496,331 participants (54.6% women) free of dementia at baseline.

Measurements

History of fracture was self-reported via touchscreen questionnaires at baseline. The primary outcome was all-cause dementia.

Results

Both any fracture and fragility fracture were significantly associated with an increased risk of subsequent all-cause dementia in men (adjusted hazard ratio (HR): 1.28; 95% confidence interval (CI): 1.14–1.43; adjusted HR: 1.48; 95% CI: 1.18–1.87, respectively), but not in women (adjusted HR: 1.04; 95% CI 0.95–1.15; adjusted HR: 1.01; 95% CI: 0.87–1.18, respectively); and these sex-differences were significant (P interaction = 0.006; P interaction = 0.007, respectively). The sex differences in the impacts of different fracture sites (including upper limb, lower limb, spine, and multiple sites) were consistent on all-cause dementia.

Conclusions

This study demonstrated that prior fracture was associated with an increased risk of dementia in men but not in women, and the sex difference was significant. Previous fracture may be an important marker for identifying subsequent dementia in middle-aged and older men.

中文翻译：

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先前骨折与随后发生痴呆症的风险之间的性别差异：一项纵向队列研究

背景

骨折史与痴呆风险增加有关；然而，尚不确定既往骨折与随后发生痴呆的风险之间是否存在性别差异。

目标

调查性别是否改变了先前骨折与随后患痴呆症风险之间的关系。

设计

前瞻性队列研究。

环境

英国生物银行。

参加者

496,331 名参与者（54.6% 为女性）在基线时未患痴呆症。

测量

基线时通过触摸屏问卷自我报告骨折史。主要结局是全因痴呆。

结果

任何骨折和脆性骨折均与男性随后发生全因痴呆的风险增加显着相关（调整后的风险比 (HR)：1.28；95% 置信区间 (CI)：1.14–1.43；调整后的 HR：1.48；95% CI：分别为 1.18-1.87），但在女性中则不然（调整后 HR：1.04；95% CI：0.95-1.15；调整后 HR：1.01；95% CI：0.87-1.18）；这些性别差异显着（分别为 P 相互作用 = 0.006；P 相互作用 = 0.007）。不同骨折部位（包括上肢、下肢、脊柱和多个部位）对全因痴呆的影响的性别差异是一致的。

结论

这项研究表明，男性既往骨折与痴呆风险增加有关，但女性则不然，而且性别差异显着。既往骨折可能是识别中老年男性后续痴呆的重要标志。