The Silent Threats of Aging: Fear of Fragile Bones, Stiff Arteries, or Time’s Inevitable Betrayal? An Age-Matched Study

Avramovska, Maja and Avramovski, Petar and Todorovska, Liljana and Taleva, Biljana and Sotiroski, Kosta and Zdraveski, Dejan (2025) The Silent Threats of Aging: Fear of Fragile Bones, Stiff Arteries, or Time’s Inevitable Betrayal? An Age-Matched Study. JOURNAL OF CLINICAL MEDICINE OF KAZAKHSTAN, 22 (6). pp. 10-18. ISSN 2313-1519

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Abstract

Introduction: This study assessed the predictive power of femoral neck
(FN) bone mineral density (BMD) and pulse wave velocity (PWV) for fracture and
cardiovascular-related mortality over a three-year follow-up in a representative
cohort.
Methods: A total of 142 participants (54 males, 38%), aged 56 ± 7.2 years,
were enrolled in this prospective observational study. FN BMD was measured
using dual-energy X-ray absorptiometry (DXA), and carotid-to-femoral PWV
was determined via Doppler ultrasound.
Results: Mean PWV was significantly higher in non-survivors compared
to survivors (10.9 ± 3.2 m/s vs. 8.6 ± 2.1 m/s, p = 0.0041). FN BMD was lower in
non-survivors (0.658 ± 0.131 g/cm²) than in survivors (0.852 ± 0.150 g/cm², p =
0.002). Logistic regression identified PWV as a strong determinant of mortality
[coefficient: 0.1593; odds ratio (OR): 1.17; 95% confidence interval (CI): 1.04–1.32; p
= 0.01], while FN BMD also showed significance (coefficient: –6.6336; OR: 0.0013;
95% CI: 0.000–0.156; p = 0.0064). However, in age-matched analysis, only PWV
remained significant (OR: 2.77; 95% CI: 1.70–4.51; p < 0.0001]. Receiver operating
characteristic (ROC) analysis demonstrated superior predictive accuracy for
PWV [area under the curve (AUC): 0.958; cutoff: 11.3 m/s; sensitivity: 94.6%;
specificity: 88.1%] compared with FN BMD (AUC: 0.560).
Conclusion: PWV showed outstanding accuracy for predicting all-cause
mortality, outperforming FN BMD and remaining independent of age. These
f
indings establish PWV as a robust prognostic marker for mortality risk,
highlighting its potential role in improving clinical risk stratification for vascular
aging and cardiovascular outcomes.
Keywords: Fe

Item Type:	Article
Uncontrolled Keywords:	Femoral Neck; Pulse Wave Velocity; Osteoporosis; Bone health; Arterial Stiffness.
Subjects:	Scientific Fields (Frascati) > Medical and Health Sciences > Basic medicine Scientific Fields (Frascati) > Medical and Health Sciences > Clinical medicine Scientific Fields (Frascati) > Medical and Health Sciences > Health sciences
Divisions:	UKLO Network
Depositing User:	D-r Petar Avramovski
Date Deposited:	13 Feb 2026 08:19
Last Modified:	13 Feb 2026 08:19
URI:	https://eprints.uklo.edu.mk/id/eprint/11301

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