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Apolipoprotein ɛ4 is associated with increased risk of fall- and fracture-related hospitalisation: the Perth longitudinal study of ageing women
Pratt, Jedd Dalla Via, Jack Sale, Craig Gebre, Abadi K Stephan, Blossom CM Laws, Simon Zhu, Kun Lim, Wai H Prince, Richard L Lewis, Joshua R
Pratt, Jedd
Dalla Via, Jack
Sale, Craig
Gebre, Abadi K
Stephan, Blossom CM
Laws, Simon
Zhu, Kun
Lim, Wai H
Prince, Richard L
Lewis, Joshua R
Abstract
Apolipoprotein ɛ4 (APOE ɛ4) 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 ɛ4 status and long-term fall- and fracture-related hospitalisation risk in older women. 1276 community-dwelling women from the Perth Longitudinal Study of Ageing 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 ɛ4 with fall-, any fracture-, and hip fracture-related hospitalisations, obtained over 14.5 years from linked health records, were examined using multivariable-adjusted Cox-proportional hazard models. Over 14.5 years, 507 (39.7%) women experienced a fall-related hospitalisation, 360 (28.2%) women experienced a fracture-related hospitalisation, including 143 (11.2%) attributed to a hip fracture. In multivariable-adjusted models, compared to non-carriers, APOE ɛ4 carriers (n=297, 23.3%) had greater risk for a fall- (HR 1.48 95%CI 1.22-1.81), fracture- (HR 1.28, 95%CI 1.01-1.63) or hip fracture-related hospitalisation (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, abbreviated mental test score) were added to the multivariable model. In conclusion, APOE ɛ4 is a potential risk factor for fall- and fracture-related hospitalisation in community-dwelling older women. Screening for APOE ɛ4 could provide clinicians an opportunity to direct higher risk individuals to appropriate intervention strategies.
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2024-05-20
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Pratt J, Dalla Via J, Sale C, Gebre AK, Stephan BCM, Laws S, Zhu K, Lim WH, Prince RL, Lewis JR, Sim M. Apolipoprotein ɛ4 Is Associated With Increased Risk of Fall- and Fracture-Related Hospitalization: The Perth Longitudinal Study of Ageing Women. J Gerontol A Biol Sci Med Sci. 2024 Aug 1;79(8):glae134. doi: 10.1093/gerona/glae134.
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© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/),
which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.