Geographic variation of bone mineral density and selected risk factors for prediction of incident fracture among Canadians 50 and older

Langsetmo, Lisa; Hanley, David A.; Kreiger, Nancy; Jamal, Sophie A.; Prior, Jerilynn C.; Adachi, Jonathan D.; Davison, K. Shawn; Kovacs, Christopher S.; Anastassiades, Tassos; Tenenhouse, Alan; Goltzman, David

doi:10.1016/j.bone.2008.06.009

Cited by 22 publications

(21 citation statements)

References 34 publications

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“…For the LTC cohort, our incidence rates were similar to [15,27,28] or lower than [29,30] other published studies on institutionalized populations, particularly Chandler et al who reported a rate of 109 osteoporotic fractures per 1000 person-years [31]. Our reported rates in the community were higher than the community-based Canadian Multicentre Osteoporosis Study (CaMos) [32] although there are differences in study methodologies with CaMOS relying on patient selfreport.…”

Section: Discussionsupporting

confidence: 74%

Comparative trends in incident fracture rates for all long-term care and community-dwelling seniors in Ontario, Canada, 2002–2012

et al. 2016

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Summary-In this population-based study, we compared incident fracture rates in long-term care (LTC) versus community seniors between 2002 and 2012. Hip fracture rates declined more rapidly in LTC than in the community. An excess burden of fractures occurred in LTC for hip, pelvis, and humerus fractures in men and hip fractures only in women.Introduction-This study compares trends in incident fracture rates between long-term care (LTC) and community-dwelling seniors ≥65 years, 2002-2012.

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Section: Discussionsupporting

confidence: 74%

Comparative trends in incident fracture rates for all long-term care and community-dwelling seniors in Ontario, Canada, 2002–2012

et al. 2016

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“…In older persons with osteoporosis the bone mineral density is reduced, and the bone architecture is disrupted. Osteoporosis is a disease that is more prevalent in older persons, and more prevalent among older persons in Scandinavia and the United States than elsewhere [1][2][3][4]. Several factors have been associated with an increased risk for osteoporosis, including female gender, age, ethnicity, diet, and lifestyle [5].…”

Section: Introductionmentioning

confidence: 99%

Prediction of hip and hand fractures in older persons with or without a diagnosis of periodontitis

Persson

Berglund

Persson

et al. 2011

Bone

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“…Hamilton and Toronto results both required a one-time correction. Hamilton measurements were reduced by 1.5% starting in January 1998 and Toronto measurements were increased by 0.85% starting in September 1997 [13].…”

Section: Bone Mineral Densitymentioning

confidence: 99%

“…This resulted in 4194 men and women. Baseline and year five assessments included an extensive interviewer-administered questionnaire, lumbar BMD testing, and lateral lumbar and thoracic spine radiographs, in which lumbar anterior, middle, and posterior heights were measured manually [13].…”

Section: Sample Selectionmentioning

confidence: 99%

Predicting fracture using 2D finite element modelling

MacNeil

Adachi

Goltzman

et al. 2012

Medical Engineering & Physics

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A decrease in bone density at the hip or spine has been shown to increase the risk of fracture. A limitation of the bone mineral density (BMD) measurement is that it provides only a measure of a bone samples average density when projected onto a 2D surface. Effectively, what determines bone fracture is whether an applied load exceeds ultimate strength, with both bone tissue material properties (can be approximated through bone density), and geometry playing a role. The goal of this project was to use bone geometry and BMD obtained from radiographs and DXA measurements respectively to estimate fracture risk, using a two-dimensional finite element model (FEM) of the sagittal plane of lumbar vertebrae. The Canadian Multicenter Osteoporosis Study (CaMos) data was used for this study. There were 4194 men and women over the age of 50 years, with 786 having fractures. Each subject had BMD testing and radiographs of their lumbar vertebrae. A single two dimensional FEM of the first to fourth lumbar vertebra was automatically generated for each subject. Bone tissue stiffness was assigned based on the BMD of the individual vertebrae, and adjusted for patient age. Axial compression boundary conditions were applied with a force proportional to body mass. The resulting overall strain from the applied force was found. Men and women were analyzed separately. At baseline, the sensitivity of BMD to predict fragility fractures in women and men was 3.77 % and 0.86 %, while the sensitivity of FEM to predict fragility fractures for women and men was 10.8 % and 11.3 %. The FEM ROC curve demonstrated better performance compared to BMD. The relative risk of being considered at high fracture risk using FEM at baseline, was a better predictor of 5 year incident fragility fracture risk compared to BMD.

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Geographic variation of bone mineral density and selected risk factors for prediction of incident fracture among Canadians 50 and older

Abstract: Background-Striking geographic variation in the incidence of osteoporotic fracture has been shown in national and international studies. The contributing risk factors for this variation are not fully understood.

Cited by 22 publications

References 34 publications

Comparative trends in incident fracture rates for all long-term care and community-dwelling seniors in Ontario, Canada, 2002–2012

Comparative trends in incident fracture rates for all long-term care and community-dwelling seniors in Ontario, Canada, 2002–2012

Prediction of hip and hand fractures in older persons with or without a diagnosis of periodontitis

Predicting fracture using 2D finite element modelling

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