Determinants of Fracture Risk in a UK-population-based Cohort of Older Women: a Cross-sectional Analysis of the Cohort for Skeletal Health in Bristol and Avon (COSHIBA)

Overview

Journal Age Ageing

Publisher Oxford University Press

Specialty Geriatrics

Date 2011 Nov 24

PMID 22107913

Citations 13

Authors

Emma M Clark

Virginia C Gould

Leigh Morrison

Tahir Masud

Jon Tobias

Affiliations

Soon will be listed here.

Abstract

Background: Identification of individuals with high fracture risk from within primary care is complex. It is likely that the true contribution of falls to fracture risk is underestimated.

Methods: Cross-sectional analysis of a population-based cohort of 3,200 post-menopausal women aged 73 ± 4 years. Self-reported data were collected on fracture, osteoporosis clinical risk factors and falls/mobility risk factors. Self-reported falls were compared with recorded falls on GP computerised records. Multivariable logistic regression was used to identify independent risk factors for fracture.

Results: A total of 838 (26.2%) reported a fracture after aged 50; 441 reported falling more than once per year, but 69% of these had no mention of falls on their computerised GP records. Only age [odds ratios (OR): 1.37 per 5 year increase, 95% confidence interval (CI): 1.23-1.53], height (1.02 per cm increase, 95% CI: 1.01-1.04), weight (OR: 0.99 per kg increase, 95% CI: 0.98-0.99) and falls (OR: 1.49 for more than once per year compared with less, 95% CI: 1.13-1.94) were independent risk factors for fracture. Falls had the strongest association.

Conclusion: When identifying individuals with high fracture risk we estimate that more than one fall per year is at least twice as important as height and weight. Furthermore, using self-reported falls data is essential as computerised GP records underestimate falls prevalence.

Citing Articles

Recent fall and high imminent risk of fracture in older men and women.

Kim K, Lui L, Cummings S Age Ageing. 2022; 51(6).

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A clinical tool to identify older women with back pain at high risk of osteoporotic vertebral fractures (Vfrac): a population-based cohort study with exploratory economic evaluation.

Khera T, Hunt L, Davis S, Gooberman-Hill R, Thom H, Xu Y Age Ageing. 2022; 51(3).

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Impact of mild and moderate/severe vertebral fractures on physical activity: a prospective study of older women in the UK.

Al-Sari U, Tobias J, Clark E Osteoporos Int. 2018; 30(1):155-166.

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Feasibility and acceptability of using jumping mechanography to detect early components of sarcopenia in community-dwelling older women.

Hannam K, Hartley A, Clark E, Aihie Sayer A, Tobias J, Gregson C J Musculoskelet Neuronal Interact. 2017; 17(3):246-257.

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Habitual levels of higher, but not medium or low, impact physical activity are positively related to lower limb bone strength in older women: findings from a population-based study using accelerometers to classify impact magnitude.

Hannam K, Deere K, Hartley A, Al-Sari U, Clark E, Fraser W Osteoporos Int. 2016; 28(10):2813-2822.

PMID: 27966105 PMC: 5624975. DOI: 10.1007/s00198-016-3863-5.

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