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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #410904
Research Project: Nutrient Metabolism and Musculoskeletal Health in Older Adults

Location: Jean Mayer Human Nutrition Research Center On Aging

Title: A meta-analysis of previous falls and subsequent fracture risk in cohort studies

Author
item VANDERPUT, LIESBETH - Australian Catholic University
item JOHANSSON, HELENA - Australian Catholic University
item MCCLOSKEY, EUGENE - University Of Sheffield
item LIU, ENWU - Australian Catholic University
item SCHINI, MARIAN - University Of Sheffield
item AKESSON, KRISTINA - Lund University
item ANDERSON, FRED - University Of Massachusetts
item AZAGRA, RAFAEL - Autonomous University Of Barcelona
item BAGER, CECILIE - Nordic Bioscience As
item BEAUDART, CHARLOTTE - University Of Liege
item BISCHOFF-FERRARA, HEIKE - University Of Zurich
item BIVER, EMMANUEL - Geneva University Hospital
item BRUYERE, OLIVIER - University Of Liege
item CAULEY, JANE - University Of Pittsburgh
item CENTER, JACQUELINE - Garvan Institute Of Medical Research
item CHAPURLAT, ROLAND - University Of Lyon
item CHRISTIANSEN, CASPER - Nordic Bioscience As
item COOPER, CYRUS - University Of Southampton
item CRANDALL, CAROLYN - University Of California San Francisco (UCSF)
item CUMMINGS, STEVEN - University Of California San Francisco (UCSF)
item DA SILVA, JOSE - University Of Coimbra
item DAWSON-HUGHES, BESS - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item DIEZ-PEREZ, ADOLFO - Hospital Del Mar Medical Research Institute
item DUFOUR, ALYSSA - Harvard Medical School
item EISMAN, JOHN - Garvan Institute Of Medical Research
item ELDERS, PETRA - Amsterdam Public Health Research Institute
item FERRARI, SERGE - Geneva University Hospital
item FUJITA, YUKI - Kindai University
item FUJIWARA, SAEKO - Yasuda Women'S University
item GLUER, CLAUS - University Of Kiel
item GOLDSHTEIN, INBAL - Maccabi Healthcare Services
item GOLTZMAN, DAVID - McGill University - Canada
item GUDNASON, VILMUNDUR - Icelandic Heart Association
item HALL, JILL - University Of Edinburgh
item HANS, DIDIER - Lausanne University Hospital
item HOFF, MARI - Norwegian University Of Science And Technology
item HOLLICK, ROSEMARY - University Of Aberdeen
item HUISMAN, MARTIJN - Vrije University
item IKI, MASAYUKI - Kindai University
item SHALOM, SOPHIA - Elisha Hospital
item JONES, GRAEME - University Of Tasmania
item KARLSSON, MAGNUS - Lund University
item KHOSLA, SUNDEEP - Mayo Clinic College Of Medicine
item KIEL, DOUGLAS - Harvard Medical School
item KOH, WOON-PUAY - National University Of Singapore
item KOROMANI, FJORDA - Erasmus University
item KOTOWICZ, MARK - Deakin University
item KROGER, HEIKKI - Kuopio University Hospital
item KWOK, TIMOTHY - The Chinese University Of Hong Kong (CUHK)
item LAMY, OLIVIER - Lausanne University Hospital
item LANGHAMMER, ARNULF - Norwegian University Of Science And Technology
item LARIJANI, BAGHER - Tehran University Of Medical Sciences
item LIPPUNER, KURT - Bern University Of Applied Sciences
item MCGUIGAN, FIONA - Lund University
item MELLSTROM, DAN - University Of Gothenburg
item MERLIJN, THOMAS - Amsterdam Public Health Research Institute
item NGUYEN, TUAN - University Of Technology Sydney
item NORDSTROM, ANNA - The Arctic University Of Norway (UIT)
item NORDSTROM, PETER - Uppsala University
item O'NEILL, TERRENCE - University Of Manchester
item OBERMAYER-PIETSCH, BARBARA - Medical University Of Graz
item OHLSSON, CLAES - University Of Gothenburg
item ORWOLL, ERIC - Oregon Health & Science University
item PASCO, JULIE - Deakin University
item RIVADENEIRA, FERNANDO - Erasmus University
item SCHOTT, ANN-MARIE - University Of Lyon
item SHIROMA, ERIC - National Institute On Aging (NIA, NIH)
item SIGGEIRSDOTTIR, KRISTIN - Icelandic Heart Association
item SIMONSICK, ELEANOR - National Institute On Aging (NIA, NIH)
item SORNAY-RENDU, ELIZABETH - University Of Lyon
item SUND, REIJO - University Of Eastern Finland
item SWART, KARIN - Amsterdam Public Health Research Institute
item SZULC, PAWEL - University Of Lyon
item TAMAKI, JUNKO - Osaka Medical College
item TORGERSON, DAVID - York University
item VAN SCHOOR, NATASJA - Amsterdam Public Health Research Institute
item VAN STAA, TJEERD - University Of Manchester
item VILA, JOAN - Hospital Del Mar Medical Research Institute
item WAREHAM, NICKOLAS - University Of Cambridge
item WRIGHT, NICOLE - University Of Alabama At Birmingham
item YOSHIMURA, NIROKO - University Of Tokyo
item ZILLIKENS, MARIA - Erasmus University
item ZWART, MARTA - University Of Girona
item HARVEY, NICHOLAS - University Of Southampton
item LORENTZON, MATTIAS - Australian Catholic University
item LESLIE, WILLIAM - University Of Manitoba
item KANIS, JOHN - Australian Catholic University

Submitted to: Osteoporosis International
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/27/2023
Publication Date: 1/17/2024
Citation: Vanderput, L., Johansson, H., McCloskey, E.V., Liu, E., Schini, M., Akesson, K.E., Anderson, F.A., Azagra, R., Bager, C.L., Beaudart, C., Bischoff-Ferrara, H., Biver, E., Bruyere, O., Cauley, J.A., Center, J.R., Chapurlat, R., Christiansen, C., Cooper, C., Crandall, C.J., Cummings, S., da Silva, J.A., Dawson-Hughes, B., Diez-Perez, A., Dufour, A.B., Eisman, J.A., Elders, P., Ferrari, S., Fujita, Y., Fujiwara, S., Gluer, C.C., Goldshtein, I., Goltzman, D., Gudnason, V., Hall, J., Hans, D., Hoff, M., Hollick, R.J., Huisman, M., Iki, M., Shalom, S.I., Jones, G., Karlsson, M., Khosla, S., Kiel, D., Koh, W., Koromani, F., Kotowicz, M., Kroger, H., Kwok, T., Lamy, O., Langhammer, A., Larijani, B., Lippuner, K., Mcguigan, F.E., Mellstrom, D., Merlijn, T., Nguyen, T.V., Nordstrom, A., Nordstrom, P., O'Neill, T.W., Obermayer-Pietsch, B., Ohlsson, C., Orwoll, E.S., Pasco, J., Rivadeneira, F., Schott, A., Shiroma, E.J., Siggeirsdottir, K., Simonsick, E.M., Sornay-Rendu, E., Sund, R., Swart, K.M., Szulc, P., Tamaki, J., Torgerson, D., van Schoor, N.C., van Staa, T.P., Vila, J., Wareham, N.J., Wright, N.C., Yoshimura, N., Zillikens, M.C., Zwart, M., Harvey, N.C., Lorentzon, M., Leslie, W.D., Kanis, J.A. 2024. A meta-analysis of previous falls and subsequent fracture risk in cohort studies. Osteoporosis International. https://doi.org/10.1007/s00198-023-07012-1.
DOI: https://doi.org/10.1007/s00198-023-07012-1

Interpretive Summary: The relationship between self-reported falls and fracture risk was estimated in an analysis of 906,532 individuals from 46 cohorts around the globe, including the STOP IT study conducted at the USDA HNRCA. Twenty-three percent of the 906,532 participants reported falling in the past year. Having a fall in the last year was associated with a 41% increase in having a fracture in the women and a 41% increase in the men. This analysis establishes the importance of a prior fall as a risk factor for fracture and provides the justification for including a fall in the last year as a risk factor in the FRAX algorithm that is used globally to assess fracture risk.

Technical Abstract: The relationship between self-reported falls and fracture risk was estimated in an international meta-analysis of individual-level data from 46 prospective cohorts. Previous falls were associated with an increased fracture risk in women and men and should be considered as an additional risk factor in the FRAX algorithm. Introduction. Previous falls are a well-documented risk factor for subsequent fracture but have not yet been incorporated into the FRAX algorithm. The aim of this study was to evaluate, in an international meta-analysis, the association between previous falls and subsequent fracture risk and its relation to sex, age, duration of follow-up, and bone mineral density (BMD). Methods. The resource comprised 906,532 women and men (64.2% female) from 46 prospective cohorts. Previous falls were uniformly defined as any fall occurring during the previous year in 43 cohorts; the remaining three cohorts had a different question construct. The association between previous falls and fracture risk (any clinical fracture, osteoporotic fracture, major osteoporotic fracture, and hip fracture) was examined using an extension of the Poisson regression model in each cohort and each sex, followed by random-effects meta-analyses of the weighted beta coefficients. Results. Falls in the past year were reported in 21.3% of individuals. During a follow-up of 9,114,594 person-years, 87,518 fractures occurred of which 19,557 were hip fractures. A previous fall was associated with a significantly increased risk of any clinical fracture both in women (hazard ratio [HR] 1.41, 95% confidence interval [CI] 1.32-1.50) and men (HR 1.51, 95% CI 1.31-1.73). The HRs were of similar magnitude for osteoporotic, major osteoporotic fracture, and hip fracture. Sex significantly modified the association between previous fall and fracture risk, with predictive values being higher in men than in women (e.g., for major osteoporotic fracture, HR 1.52 (95% CI 1.27-1.82) in men vs. HR 1.30 (95% CI 1.19-1.43) in women, P for interaction = 0.0074). The HRs associated with previous falls decreased with age in women and with duration of follow-up in men and women for most fracture outcomes. Overall, there was no evidence of an interaction between falls and BMD for fracture risk. Subsequent risk for a major osteoporotic fracture increased with each additional previous fall in women and men. Conclusion. A previous self-reported fall confers an increased risk of fracture that is largely independent of BMD. Previous falls should be considered as an additional risk factor in future iterations of FRAX to improve fracture risk prediction.