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Age-related macular degeneration tied to fracture risk in patients with osteoporosis

Publish date:: November 18, 2020

Key clinical point: Patients with osteoporosis with age-related macular degeneration (AMD) are at a significantly higher risk of developing spine and hip fractures.

Major finding: The AMD vs. non-AMD group had a significantly higher risk for spine and hip fractures (hazard ratio [HR], 1.09; P less than .001 and HR, 1.18; P = .001; respectively). The risk for mortality was significantly higher in patients with osteoporosis with older age, male sex, and all types of comorbidities (P less than .05), except for hyperthyroidism (P = .200).

Study details: This Taiwanese nationwide study included 1,206,247 patients with osteoporosis using insurance claims data. After propensity score matching, 13,548 and 54,336 patients were analyzed in the AMD and non-AMD groups, respectively.

Disclosures: The study was supported by Chang Gung Medical Research Foundation. The authors declared no conflicts of interest.

Commentary

“Decreased vision contributes to fractures. Age-related macular degeneration (AMD) is associated with increased risk of falls, but the relationship between AMD and fragility fractures is poorly understood. In this study from Taiwan the authors used claims data (1996-2011) to investigate the association between AMD and fractures. Patients older than 50 years of age were defined as having osteoporosis based in ICD9 codes. Important exclusion criteria were: prior osteoporosis treatment, prior fracture, HIV, metastatic bone tumors. Each patient with AMD was matched for age, sex and comorbidities to 4 patients without AMD.

Compared to patients without AMD, those with AMD had a 9% higher risk for being hospitalized for a spine fracture and 18% higher risk for being hospitalized for a hip fracture. Older age, male sex and all types of comorbidity with the exception of hyperthyroidism were associated with higher probability of death in this cohort. Further studies are needed to investigate whether the severity of AMD or AMD treatment modify this association.”