Determinants of imminent fracture risk in postmenopausal women with osteoporosis

Abstract

In elderly women with osteoporosis, prior fracture, low BMD, impaired physical functioning, poorer general health, and recent falls were all direct predictors of imminent (in next year) fracture risk. Prior fracture, older age, worse health, impaired cognitive functioning, and recent falls indirectly increased imminent risk by reducing physical functioning/general health. Introduction This study was designed to examine determinants of imminent risk of osteoporotic fracture (i.e., next 1-2 years) in postmenopausal women. Methods This retrospective cohort study used data from Caucasian women age 65 or older with osteoporosis who participated in the observational Study of Osteoporotic Fractures (SOF). We examined potential direct and indirect predictors of hip and nonvertebral fractures in 1-year follow-up intervals including anthropometric measures, bone mineral density (T-score), fracture since age 50, physical function, cognition, medical conditions, recent (past year) falls, and lifestyle factors. Clinically related variables were grouped into constructs via factor analysis. These constructs and selected individual variables were incorporated into a theoretical structural equation model to evaluate factors that influence imminent risk. Results Among 2261 patients, 19.4% had a nonvertebral fracture and 5.5% had a hip fracture within 1 year of a study visit between 1992 and 2008. Prior fracture, lower T-scores, lower physical functioning, and recent falls all directly increased 1-year risk of nonvertebral fracture. For both nonvertebral and hip fractures, prior fracture and recent falls influenced risk indirectly through general health, while cognition influenced risk via physical functioning. Age influenced both physical functioning and general health. Conclusions Several established risk factors for 10-year fracture risk also played a role in predicting imminent risk of fracture (e.g., T-scores, prior fracture), as did falls, cognition, physical functioning, and general health. Fracture risk assessments should also consider falls and fall risk factors as well as established bone-related risk factors in assessing imminent fracture risk.

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“…Osteoporosis (OP) is a progressive systemic bone disease ( Kanis et al, 2019 ) that is characterized by a decreased bone mass and deterioration of bone microstructure, both of which will lead to an increased risk of brittle fracture, which is more common in postmenopausal women ( Barron et al, 2020 ). OP complicated with brittle fracture often requires surgical treatment, and many human and financial resources are needed for treatment and nursing care.…”

METTL3‐m6A methylase regulates the osteogenic potential of bone marrow mesenchymal stem cells in osteoporotic rats via the Wnt signalling pathway

“…As the worldwide population is rapidly aging, osteoporosis (OP) could become a global health-care challenge. 1,2 OP has low bone mineral density and structural degradation of bones and increases the risk of fracture in OP patients. 1,[3][4][5] Postmenopausal women suffer from OP due to the rapid decline in oestrogen levels.…”

“…1,2 OP has low bone mineral density and structural degradation of bones and increases the risk of fracture in OP patients. 1,[3][4][5] Postmenopausal women suffer from OP due to the rapid decline in oestrogen levels. 6,7 At the same time, the bone loss caused by menopause usually precedes age-related bone loss, so postmenopausal women may develop osteoporotic fractures earlier than men of the same age.…”

“…6,7 At the same time, the bone loss caused by menopause usually precedes age-related bone loss, so postmenopausal women may develop osteoporotic fractures earlier than men of the same age. 1,[8][9][10] Treatments for osteoporotic fractures include drug, non-drug and stem cell therapies. [11][12][13] However, medical treatment has the disadvantages of not reversing the existing bone loss and potentially causing serious side effects.…”

Fatores associados a fraturas de fêmur em uma coorte de mulheres idosas

“…Para a OMS, o diagnóstico de osteoporose pode ser estabelecido na presença de fratura por trauma mínimo sem a necessidade de avaliação complementar ou laboratorial (Radominski et al, 2017). Adicionalmente, em mulheres com idade igual ou superior a 65 anos e com osteoporose, fratura prévia, baixo IMC, restrição na funcionalidade, precário estado de saúde e histórico atual de quedas são considerados preditores diretos de iminente risco de fratura (Barron et al, 2020).…”