Abstract：
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.
OBJECTIVE: To investigate whether sex modified the relationship between prior fracture and subsequent risk of dementia.
METHODS: Prospective cohort study.
METHODS: UK Biobank.
METHODS: 496,331 participants (54.6% women) free of dementia at baseline.
METHODS: 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.
OBJECTIVE: To investigate whether sex modified the relationship between prior fracture and subsequent risk of dementia.
METHODS: Prospective cohort study.
METHODS: UK Biobank.
METHODS: 496,331 participants (54.6% women) free of dementia at baseline.
METHODS: 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.
摘要：
背景：骨折史与痴呆风险增加有关；然而，目前尚不清楚骨折发生前和痴呆发生后风险之间是否存在性别差异.
目的：研究性别是否改变了既往骨折与后续痴呆风险之间的关系。
方法：前瞻性队列研究。
方法：英国生物银行。
方法：496,331名参与者（54.6%女性）在基线时没有痴呆。
方法：在基线时通过触摸屏问卷自我报告骨折史。主要结果是全因痴呆。
结果：任何骨折和脆性骨折均与男性随后的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：1.18-1.87），但在女性中没有(调整后的HR:1.04;95%CI0.95-1.15;调整后的HR:1.01;95%CI:0.87-1.18);这些性别差异是显著的(P交互作用=0.006;P交互作用=0.007)。不同骨折部位(包括上肢、下肢,脊柱,和多个站点）在全因痴呆症上是一致的。
结论：这项研究表明，男性的既往骨折与痴呆风险增加有关，而女性则没有。性别差异显著。先前的骨折可能是识别中年和老年男性随后的痴呆的重要标志。
目的：研究性别是否改变了既往骨折与后续痴呆风险之间的关系。
方法：前瞻性队列研究。
方法：英国生物银行。
方法：496,331名参与者（54.6%女性）在基线时没有痴呆。
方法：在基线时通过触摸屏问卷自我报告骨折史。主要结果是全因痴呆。
结果：任何骨折和脆性骨折均与男性随后的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：1.18-1.87），但在女性中没有(调整后的HR:1.04;95%CI0.95-1.15;调整后的HR:1.01;95%CI:0.87-1.18);这些性别差异是显著的(P交互作用=0.006;P交互作用=0.007)。不同骨折部位(包括上肢、下肢,脊柱,和多个站点）在全因痴呆症上是一致的。
结论：这项研究表明，男性的既往骨折与痴呆风险增加有关，而女性则没有。性别差异显著。先前的骨折可能是识别中年和老年男性随后的痴呆的重要标志。
