The relationship among history of falls, osteoporosis, and fractures in postmenopausal women.
OBJECTIVE
To study the relative contribution of osteoporosis and falls to the occurrence of symptomatic fractures in postmenopausal women.


METHODS
Retrospective survey of current osteoporosis in relation to falls and fractures in the preceding year.


METHODS
Patients of general practitioners of the area around a Belgian university.


METHODS
A total of 2649 consecutive postmenopausal women (mean age, 61y; range, 45-91y).


METHODS
Not applicable.


METHODS
Current bone density measurements (single-photon absorptiometry in the forearm) were analyzed in relation to self-reported incidence of falls and fractures in the preceding year.


RESULTS
Osteoporosis was found in 15% of the patients, 19% reported 1 or more falls during the preceding year, and 1.8% had a fracture during the preceding year. The age-adjusted risk for a fracture in the past 12 months for a 1 standard deviation decrease in bone density was 1.9 (95% confidence interval [CI], 1.4-2.5; P<.01). Adjusted risk for age, bone density, and body mass index (BMI) for a fracture in the past 12 months in patients who reported a fall was 6.0 (95% CI, 3.1-11.5; P<.001). Compared with women without osteoporosis and without a fall, women with osteoporosis without a fall had an age- and BMI-adjusted fracture risk of 2.8 (95% CI, 0.6-12.8; P<.10), and women with osteoporosis and a fall had an adjusted-fracture risk of 24.8 (95% CI, 6.9-88.6; P<.0001).


CONCLUSIONS
Falls are a major contributing factor to the occurrence of symptomatic fractures in postmenopausal women, independent of and additive to the risk attributable to age and osteoporosis.
Geusens
Piet
P
Biomedical Research Institute, Limburgs Universitair Centrum, Diepenbeek, Belgium. piet.geusens@ping.be
Autier
Philip
P
Boonen
Steven
S
Vanhoof
Johan
J
Declerck
Kathy
K
Raus
Jef
J
D015502:Absorptiometry, Photon; D000058:Accidental Falls / Q000706:statistics & numerical data*; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D017698:Postmenopause; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment