Ten-year incident osteoporosis-related fractures in the population-based Canadian Multicentre Osteoporosis Study:​ comparing site and age-specific risks in women and men

Prior, Jerilynn C.<sup>1</sup>; Langsetmo, Lisa<sup>2</sup>; Lentle, Brian C.<sup>1</sup>; Berger, Claudie<sup>2</sup>; Goltzman, David<sup>3</sup>; Kovacs, Christopher S.<sup>4</sup>; Kaiser, Stephanie M.<sup>5</sup>; Adachi, Jonathan D.<sup>6</sup>; Papaioannou, Alexandra<sup>6</sup>; Anastassiades, Tassos<sup>7</sup>; Towheed, Tanveer<sup>7</sup>; Josse, Robert G.<sup>8</sup>; Brown, Jacques P.<sup>9</sup>; Leslie, William D.<sup>10</sup>; Kreiger, Nancy<sup>8</sup>

Affiliations

¹University of British Columbia, Vancouver, Canada

²CaMos National Coordinating Centre, McGill University, Montreal, Canada

³McGill University, Montreal, Canada

⁴Memorial University, St John's, Canada

⁵Dalhousie University, Halifax, Canada

⁶McMaster University, Hamilton, Canada

⁷Queen's University, Kingston, Canada

⁸University of Toronto, Toronto, Canada

⁹Laval University, Quebec City, Canada

¹⁰University of Manitoba, Winnipeg, Canada

Abstract and keywords

Background: Population-based incident fracture data aid fracture prevention and therapy decisions. Our purpose was to describe 10-year site-specific cumulative fracture incidence by sex, age at baseline, and degree of trauma with/without consideration of competing mortality in the Canadian Multicentre Osteoporosis Study adult cohort.

Methods: Incident fractures and mortality were identified by annual postal questionnaires to the participant or proxy respondent. Date, site and circumstance of fracture were gathered from structured interviews and medical records. Fracture analyses were stratified by sex and age at baseline and used both Kaplan–Meier and competing mortality methods.

Results: The baseline (1995–97) cohort included 6314 women and 2789 men (aged 25–84 years; mean ± SD 62 ± 12 and 59 ± 14, respectively), with 4322 (68%) women and 1732 (62%) men followed to year-10. At least one incident fracture occurred for 930 women (14%) and 247 men (9%). Competing mortality exceeded fracture risk for men aged 65 + years at baseline. Age was a strong predictor of incident fractures especially fragility fractures, with higher age gradients for women vs. men. Major osteoporotic fracture (MOF) (hip, clinical spine, forearm, humerus) accounted for 41–74% of fracture risk by sex/age strata; in women all MOF sites showed age-related increases but in men only hip was clearly age-related. The most common fractures were the forearm for women and the ribs for men. Hip fracture incidence was the highest for the 75–84 year baseline age-group with no significant difference between women 7.0% (95% CI 5.3, 8.9) and men 7.0% (95% CI 4.4, 10.3).

Interpretation: There are sex differences in the predominant sites and age-gradients of fracture. In older men, competing mortality exceeds cumulative fracture risk.

Keywords: Population-based; 10-year fracture incidence; Hip fracture; Clinical vertebral fracture; Sex; Fracture prediction

Links

DOI: 10.1016/j.bone.2014.10.026

PubMed: 25451323

WoS: 000347770000030

History

Received: 2014-06-17

Revised: 2014-10-29

Accepted: 2014-10-31

Online: 2014-11-7

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Cited By (7)

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2020	McKay M, Jackman TM, Hussein AI, Guermazi A, Liu J, Morgan EF. Association of vertebral endplate microstructure with bone strength in men and women. Bone. February 2020;131:115147.
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2020	Li G, Leslie WD, Kovacs CS, Prior J, Josse RG, Towheed T, Davison KS, Thabane L, Papaioannou A, Levine MAH, Goltzman D, Zeng J, Qi Y, Tian J, Adachi JD; Canadian Multicentre Osteoporosis Study (CaMos) Research Group. Combining frailty and trabecular bone score did not improve predictive accuracy in risk of major osteoporotic fractures. J Bone Miner Res. June 2020;35(6):1058-1064.
2020	Tran T, Bliuc D, Pham HM, van Geel T, Adachi JD, Berger C, van den Bergh J, Eisman JA, Geusens P, Goltzman D, Hanley DA, Josse RG, Kaiser SM, Kovacs CS, Langsetmo L, Prior JC, Nguyen TV, Center JR; CaMoS Research Group. A risk assessment tool for predicting fragility fractures and mortality in the elderly. J Bone Miner Res. October 2020;35(10):1923-1934.
2020	Dotevall A, Barrenäs M-L, Landin-Wilhelmsen K. Hearing loss but not bone-regulating hormones predicts fractures in older women: a 17-year follow-up of the Gothenburg BEDA study. Osteoporos Int. March 2020;31(3):557-565.
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