Arthritis increases the risk for fractures - Results from the women's health initiative

Nicole C. Wright*, Jeffrey R. Lisse, Brian T. Walitt, Charles B. Eaton, Zhao Chen, Elizabeth Nabel, Jacques Rossouw, Shari Ludlam, Linda Pottern, Joan McGowan, Leslie Ford, Nancy Geller, Ross Prentice, Garnet Anderson, Andrea LaCroix, Charles L. Kooperberg, Ruth E. Patterson, Anne McTiernan, Sally Shumaker, Evan SteinSteven Cummings, Sylvia Wassertheil-Smoller, Aleksandar Rajkovic, Jo Ann Manson, Annlouise R. Assaf, Lawrence Phillips, Shirley Beresford, Judith Hsia, Rowan Chlebowski, Evelyn Whitlock, Bette Caan, Jane Morley Kotchen, Barbara V. Howard, Linda Van Horn, Henry Black, Marcia L. Stefanick, Dorothy Lane, Rebecca Jackson, Cora E. Lewis, Tamsen Bassford, Jean Wactawski-Wende, John Robbins, F. Allan Hubbell, Lauren Nathan, Robert D. Langer, Margery Gass, Marian Limacher, David Curb, Robert Wallace, Judith Ockene, Norman Lasser, Mary Jo O'Sullivan, Karen Margolis, Robert Brunner, Gerardo Heiss, Lewis Kuller, Karen C. Johnson, Robert Brzyski, Gloria E. Sarto, Mara Vitolins, Susan Hendrix

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

76 Scopus citations


Objective. To examine the relationship between arthritis and fracture. Methods. Women were classified into 3 self-reported groups at baseline: no arthritis (n = 83,295), osteoarthritis (OA; n = 63,402), and rheumatoid arthritis (RA; n = 960). Incident fractures were self-reported throughout followup. Age-adjusted fracture rates by arthritis category were generated, and the Cox proportional hazards model was used to test the association between arthritis and fracture. Results. After an average of 7.80 years, 24,137 total fractures were reported including 2559 self-reported clinical spinal fractures and 1698 adjudicated hip fractures. For each fracture type, age-adjusted fracture rates were highest in the RA group and lowest in the nonarthritic group. After adjustment for several covariates, report of arthritis was associated with increased risk for spine, hip, and any clinical fractures. Compared to the nonarthritis group, the risk of sustaining any clinical fracture in the OA group was HR 1.09 (95% CI 1.05, 1.13; p < 0.001) and HR 1.49 (95% CI 1.26, 1.75; p < 0.001) in the RA group. The risk of sustaining a hip fracture was not statistically increased in the OA group (HR 1.11; 95% CI 0.98, 1.25; p = 0.122) compared to the nonarthritis group; however, the risk of hip fracture increased significantly (HR 3.03; 95% CI 2.03, 4.51; p < 0.001) in the RA group compared to the nonarthritis group. Conclusion. The increase in fracture risk confirms the importance of fracture prevention in patients with RA and OA. The Journal of Rheumatology

Original languageEnglish (US)
Pages (from-to)1680-1688
Number of pages9
JournalJournal of Rheumatology
Issue number8
StatePublished - Aug 2011


  • Arthritis
  • Epidemiology
  • Fracture
  • Postmenopausal women

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology


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