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Fracture risk and health profiles differ according to relationship status: findings from the Hertfordshire Cohort Study

Fracture risk and health profiles differ according to relationship status: findings from the Hertfordshire Cohort Study
Fracture risk and health profiles differ according to relationship status: findings from the Hertfordshire Cohort Study

Registry studies have suggested associations between relationship status and fracture risk. We considered associations between relationship status and incident fracture in the Hertfordshire Cohort Study, comprising community-dwelling older adults, and explored associations between socioeconomic and lifestyle factors with relationship status. 2997 participants completed a baseline questionnaire (1998–2004) and clinic visit. Participants were followed up until December 2018 using Hospital Episode Statistics, which report clinical outcomes using codes from the 10th revision of the International Classification of Diseases (ICD-10); these codes were used to ascertain incident fractures. Relationship status (not currently married/cohabiting vs currently married/cohabiting) at baseline was examined in relation to incident fracture using Cox regression. Associations between baseline characteristics and relationship status were examined using logistic regression. Mean baseline age was 66.2 years. 80% were married/cohabiting at baseline; 15% had an incident fracture (mean (SD) follow-up duration: 14.4 (4.5) years). The following were related to greater likelihood of not being married/cohabiting: older age (women only); higher BMI (women only); current smoking; high alcohol consumption (men only); poorer diet quality (men only); lower physical activity; leaving school before age 15 (women only); and not owning one’s home. Those not married/cohabiting had greater risk of incident fracture compared to those who were (age-adjusted hazard ratios (95% CI) 1.58 (1.06, 2.38) among men, 1.35 (1.06, 1.72) among women); associations were attenuated after accounting for the above factors associated with relationship status in the corresponding sex. This suggests that differences in health profiles and lifestyle according to relationship status may explain the association between relationship status and fracture risk.

Epidemiology, Fracture, Lifestyle, Osteoporosis, Relationship status, Socioeconomic
0171-967X
461–467
Westbury, Leo
5ed45df3-3df7-4bf9-bbad-07b63cd4b281
Pearse, Millie
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Bevilacqua, Gregorio
e93e3b18-7d1e-4da5-9fcd-e6b4637e1c2e
Fuggle, Nicholas
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Ward, Kate
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Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Dennison, Elaine
ee647287-edb4-4392-8361-e59fd505b1d1
Westbury, Leo
5ed45df3-3df7-4bf9-bbad-07b63cd4b281
Pearse, Millie
9730e5c3-0382-4ed7-8eaa-6932ab09ec15
Bevilacqua, Gregorio
e93e3b18-7d1e-4da5-9fcd-e6b4637e1c2e
Fuggle, Nicholas
9ab0c81a-ac67-41c4-8860-23e0fdb1a900
Ward, Kate
39bd4db1-c948-4e32-930e-7bec8deb54c7
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Dennison, Elaine
ee647287-edb4-4392-8361-e59fd505b1d1

Westbury, Leo, Pearse, Millie, Bevilacqua, Gregorio, Fuggle, Nicholas, Ward, Kate, Cooper, Cyrus and Dennison, Elaine (2024) Fracture risk and health profiles differ according to relationship status: findings from the Hertfordshire Cohort Study. Calcified Tissue International, 114 (5), 461–467. (doi:10.1007/s00223-024-01194-4).

Record type: Article

Abstract

Registry studies have suggested associations between relationship status and fracture risk. We considered associations between relationship status and incident fracture in the Hertfordshire Cohort Study, comprising community-dwelling older adults, and explored associations between socioeconomic and lifestyle factors with relationship status. 2997 participants completed a baseline questionnaire (1998–2004) and clinic visit. Participants were followed up until December 2018 using Hospital Episode Statistics, which report clinical outcomes using codes from the 10th revision of the International Classification of Diseases (ICD-10); these codes were used to ascertain incident fractures. Relationship status (not currently married/cohabiting vs currently married/cohabiting) at baseline was examined in relation to incident fracture using Cox regression. Associations between baseline characteristics and relationship status were examined using logistic regression. Mean baseline age was 66.2 years. 80% were married/cohabiting at baseline; 15% had an incident fracture (mean (SD) follow-up duration: 14.4 (4.5) years). The following were related to greater likelihood of not being married/cohabiting: older age (women only); higher BMI (women only); current smoking; high alcohol consumption (men only); poorer diet quality (men only); lower physical activity; leaving school before age 15 (women only); and not owning one’s home. Those not married/cohabiting had greater risk of incident fracture compared to those who were (age-adjusted hazard ratios (95% CI) 1.58 (1.06, 2.38) among men, 1.35 (1.06, 1.72) among women); associations were attenuated after accounting for the above factors associated with relationship status in the corresponding sex. This suggests that differences in health profiles and lifestyle according to relationship status may explain the association between relationship status and fracture risk.

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Accepted/In Press date: 2 February 2024
e-pub ahead of print date: 18 March 2024
Published date: May 2024
Additional Information: Publisher Copyright: © The Author(s) 2024.
Keywords: Epidemiology, Fracture, Lifestyle, Osteoporosis, Relationship status, Socioeconomic

Identifiers

Local EPrints ID: 486807
URI: http://eprints.soton.ac.uk/id/eprint/486807
ISSN: 0171-967X
PURE UUID: 0e83b53c-1958-44ca-b6cf-b93b59d3c915
ORCID for Leo Westbury: ORCID iD orcid.org/0009-0008-5853-8096
ORCID for Gregorio Bevilacqua: ORCID iD orcid.org/0000-0001-7819-1482
ORCID for Nicholas Fuggle: ORCID iD orcid.org/0000-0001-5463-2255
ORCID for Kate Ward: ORCID iD orcid.org/0000-0001-7034-6750
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Elaine Dennison: ORCID iD orcid.org/0000-0002-3048-4961

Catalogue record

Date deposited: 06 Feb 2024 17:44
Last modified: 14 Aug 2024 01:56

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Contributors

Author: Leo Westbury ORCID iD
Author: Millie Pearse
Author: Gregorio Bevilacqua ORCID iD
Author: Nicholas Fuggle ORCID iD
Author: Kate Ward ORCID iD
Author: Cyrus Cooper ORCID iD
Author: Elaine Dennison ORCID iD

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