A broken rib or upper-arm bone might be more than a painful inconvenience. For some, it could increase the odds of dying in the months that follow. It is known that older adults’ mortality rates rise following hip fractures, but new research from Australia’s University of New South Wales, University of Southern Denmark and elsewhere found that other broken bones are associated with elevated mortality risks as well—and some older adults are at far greater risk than others.

In addition to hips, broken ribs, vertebrae and upper-arm and upper-leg bones are associated with increased mortality rates. Breaks to bones located farther from the torso, including hands, feet, ankles, wrists and forearms, were not associated with increased mortality rates.

Who is most at risk? Post-fracture fatality rates are greatest among adults who have preexisting health problems such as diabetes, cancer, cardiovascular and—for men but not women—liver/inflammatory disease. But not every patient who has one of these preexisting issues is at elevated risk following a fracture—patients who have multiple serious health issues are in the most danger. Example: Otherwise healthy people with diabetes without any associted complications may have post-fracture fatality rates similar to those of people without diabetes…but diabetics who also suffer from associated heart or kidney disease are at far greater risk.

What to do: Adults over age 50 who have multiple serious chronic health issues should take an aggressive approach to fracture prevention—discuss balance and bone-strength concerns and treatment options with doctors ideally before breaking a bone in a fall and certainly after a break. Problem: Doctors sometimes fail to prescribe osteoporosis medications to patients who have multiple major health issues—bone strength seems like the least of these patients’ problems. But the elevated post-fracture fatality risk suggests that osteoporosis medication could be a potential lifesaver.

Even relatively healthy older adults who experience fractures to bones in or near the torso as a result of falls should discuss bone strength and balance concerns with their doctors. In fact, have these conversations even if the fracture is to an extremity. A broken hand or foot isn’t directly associated with elevated risk of dying, but any break is associated with increased odds of broken bones in the years ahead—the next fracture might be more problematic.

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