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We utilized stored serum from the Cardiovascular Health Study in 1992\u20131993 to examine the relationship between levels of the essential amino acid tryptophan (trp) and its oxidized and nonoxidized metabolites to risk for incident hip fractures and mortality over 12\u2009years of follow\u2010up. We included 131 persons who sustained a hip fracture during this time period and 131 without a hip fracture over these same 12\u2009years of follow\u2010up; 58% female and 95% White. Weighted multivariable Cox hazards models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI) of incident hip fracture associated with a one standard deviation (SD) higher trp or its metabolites exposure. Relative risk regression was used to evaluate the cross\u2010sectional association of trp and its metabolites with frailty. Higher serum levels of trp were significantly associated with lower risk of incident hip fractures (HR\u2009=\u20090.75 per SD of trp (95% CI 0.57\u20130.99) but were not significantly associated with mortality or frailty status by Freid's frailty index. There were no statistically significant associations between any of the oxidized or nonoxidized products of trp with incident hip fractures (<jats:italic>p<\/jats:italic>\u2009\u2265\u20090.64), mortality (<jats:italic>p<\/jats:italic>\u2009\u2265\u20090.20), or cross\u2010sectional frailty status (<jats:italic>p<\/jats:italic>\u2009\u2265\u20090.13) after multiple testing adjustment. Randomized clinical trials examining whether increasing trp intake is beneficial for osteoporosis are needed. \u00a9 2023 The Authors. <jats:italic>JBMR Plus<\/jats:italic> published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.<\/jats:p>","DOI":"10.1002\/jbm4.10801","type":"journal-article","created":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T20:30:18Z","timestamp":1692649818000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Association of Tryptophan and Its Metabolites With Incident Hip Fractures, Mortality, and Prevalent Frailty in Older Adults: The Cardiovascular Health Study"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1007-5949","authenticated-orcid":false,"given":"Laura","family":"Carbone","sequence":"first","affiliation":[{"name":"Division of Rheumatology, Department of Medicine Augusta University  Augusta GA USA"},{"name":"Charlie Norwood Veterans Affairs Medical Center Veterans Affairs Health Care System  Augusta GA 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