Document Type
Journal Article
Publication Title
Journals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume
79
Issue
8
PubMed ID
38766839
Publisher
Oxford Academic
School
Centre for Precision Health / School of Medical and Health Sciences / Nutrition and Health Innovation Research Institute
Funders
National Health and Medical Research Council of Australia / Royal Perth Hospital / National Heart Foundation / Western Australian Future Health Research and Innovation
Grant Number
254627, 303169, 572604, RPHRF CAF 00/21, 102817
Abstract
Apolipoprotein ε4 (APOE ε4) may be a genetic risk factor for reduced bone mineral density (BMD) and muscle function, which could have implications for fall and fracture risk. We examined the association between APOE ε4 status and long-term fall- and fracture-related hospitalization risk in older women. A total of 1 276 community-dwelling women from the Perth Longitudinal Study of Aging Women (mean age ± SD = 75.2 ± 2.7 years) were included. At baseline, women underwent APOE genotyping and detailed phenotyping for covariates including prevalent falls and fractures, as well as health and lifestyle factors. The association between APOE ε4 and fall-, any fracture-, and hip fracture-related hospitalizations, obtained over 14.5 years from linked health records, was examined using multivariable-adjusted Cox-proportional hazard models. Over 14.5 years, 507 (39.7%) women experienced a fall-related hospitalization and 360 (28.2%) women experienced a fracture-related hospitalization, including 143 (11.2%) attributed to a hip fracture. In multivariable-adjusted models, compared to noncarriers, APOE ε4 carriers (n = 297, 23.3%) had greater risk for a fall- (hazard ratio [HR] 1.48, 95% CI: 1.22–1.81), fracture- (HR 1.28, 95% CI: 1.01–1.63), or hip fracture-related hospitalization (HR 1.83, 95% CI: 1.29–2.61). The estimates remained similar when specific fall and fracture risk factors (fear of falling, plasma 25-hydroxyvitamin D, grip strength, timed up-and-go, hip BMD, vitamin K status, prevalent diabetes, HbA1c, cholesterol, and abbreviated mental test score) were added to the multivariable model. In conclusion, APOE ε4 is a potential risk factor for fall- and fracture-related hospitalization in community-dwelling older women. Screening for APOE ε4 could provide clinicians an opportunity to direct higher-risk individuals to appropriate intervention strategies.
DOI
10.1093/gerona/glae134
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Comments
Pratt, J., Dalla Via, J., Sale, C., Gebre, A. K., Stephan, B. C., Laws, S., ... & Sim, M. (2024). Apolipoprotein ɛ4 is associated with increased risk of fall-and fracture-related hospitalisation: The Perth longitudinal study of ageing women. The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 79(8). https://doi.org/10.1093/gerona/glae134