Age-related macular degeneration is associated with an increased risk of hip fractures in the medicare database

PURPOSE: To explore the relationship between age-related macular degeneration (AMD) and incident hip fractures in the Medicare population. DESIGN: Prospective cohort study. METHODS: With a 5% random sample of Medicare beneficiaries in 1995, 8596 cases were coded with exudative AMD; 26,942 cases were coded with atrophic AMD, and 1,013,748 cases were coded without AMD. The Medicare claims from 1996 to 1999 were evaluated for hip fracture codes. The relationship between AMD and incident hip fractures was analyzed with multiple logistic regression models, with adjustment for baseline, ocular, and systemic covariates. RESULTS: In adjusted analyses, the risk of hip fractures was similar in cases that were coded with exudative AMD (odds ratio, 1.03; 95% confidence interval (CI), 0.95, 1.12) compared with cases with no AMD but was significantly higher in cases that were coded with atrophic AMD (odds ratio, 1.11; 95% CI, 1.06, 1.16). CONCLUSION: Medicare patients with a code for atrophic AMD had an 11 % greater risk of hip fractures than did patients without a code for AMD over a four-year follow-up period.