Clinical risk factors, bone density and fall history in the prediction of incident fracture among men and women

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dc.citation.issue2
dc.citation.volume52
dc.contributor.authorEdwards MH
dc.contributor.authorJameson K
dc.contributor.authorDenison H
dc.contributor.authorHarvey NC
dc.contributor.authorSayer AA
dc.contributor.authorDennison EM
dc.contributor.authorCooper C
dc.date.available2013-02
dc.date.available2012-11-07
dc.date.issued2013
dc.description.abstractThe FRAX(tr) algorithm uses clinical risk factors (CRF) and bone mineral density (BMD) to predict fracture risk but does not include falls history in the calculation. Using results from the Hertfordshire Cohort Study, we examined the relative contributions of CRFs, BMD and falls history to fracture prediction. We studied 2299 participants at a baseline clinic that included completion of a health questionnaire and anthropometric data. A mean of 5.5years later (range 2.9-8.8years) subjects completed a postal questionnaire detailing fall and fracture history. In a subset of 368 men and 407 women, bone densitometry was performed using a Hologic QDR 4500 instrument. There was a significantly increased risk of fracture in men and women with a previous fracture. A one standard deviation drop in femoral neck BMD was associated with a hazards ratio (HR) of incident fracture (adjusted for CRFs) of 1.92 (1.04-3.54) and 1.77 (1.16-2.71) in men and women respectively. A history of any fall since the age of 45years resulted in an unadjusted HR of fracture of 7.31 (3.78-14.14) and 8.56 (4.85-15.13) in men and women respectively. In a ROC curve analysis, the predictive capacity progressively increased as BMD and previous falls were added into an initial model using CRFs alone. Falls history is a further independent risk factor for fracture. Falls risk should be taken into consideration when assessing whether or not to commence medication for osteoporosis and should also alert the physician to the opportunity to target falls risk directly.
dc.description.publication-statusPublished
dc.format.extent541 - 547
dc.identifierhttp://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000313607700001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=c5bb3b2499afac691c2e3c1a83ef6fef
dc.identifier.citationBONE, 2013, 52 (2), pp. 541 - 547
dc.identifier.doi10.1016/j.bone.2012.11.006
dc.identifier.eissn1873-2763
dc.identifier.elements-id354601
dc.identifier.harvestedMassey_Dark
dc.identifier.issn8756-3282
dc.identifier.urihttps://hdl.handle.net/10179/13259
dc.relation.isPartOfBONE
dc.relation.urihttp://europepmc.org/articles/pmc3654628?pdf=render
dc.subjectEpidemiology
dc.subjectOsteoporosis
dc.subjectBMD
dc.subjectFracture
dc.subjectFall
dc.subjectFRAX
dc.subject.anzsrc06 Biological Sciences
dc.subject.anzsrc09 Engineering
dc.subject.anzsrc11 Medical and Health Sciences
dc.titleClinical risk factors, bone density and fall history in the prediction of incident fracture among men and women
dc.typeJournal article
pubs.notesNot known
pubs.organisational-group/Massey University
pubs.organisational-group/Massey University/College of Health
pubs.organisational-group/Massey University/College of Health/Research Centre for Hauora and Health
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