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Risk factors for fracture in a UK population: a prospective cohort study.

BACKGROUND
Common clinical risk factors for fracture in older women have been identified. To date, most of these risk factors have not been confirmed in a UK population.


AIM
To confirm the important risk factors for fracture in older women.


DESIGN
Comprehensive cohort study (CCS) with a nested randomized controlled trial.


METHODS
The CCS included 4292 women aged >70 years. We assessed potential risk factors for fracture, and followed-up participants for 24 months for incidence of non-vertebral fractures.


RESULTS
Odds ratios (ORs) for predicting any non-vertebral fracture were: previous fracture, 2.67 (95%CI 2.10-3.40); a fall in the last 12 months, 2.06 (95%CI 1.63-2.59); and age (per year increase), 1.03 (95%CI 1.01-1.05). ORs for predicting hip fracture were: previous fracture, 2.31 (95%CI 1.31-4.08); low body weight (<58 kg), 2.20 (95%CI 1.28-3.77); maternal history of hip fracture, 1.68 (95%CI 0.85-3.31); a fall in the last 12 months, 2.92 (95%CI 1.70-5.01); and age (per year increase), 1.09 (95%CI 1.04-1.13). ORs for predicting wrist fracture were: previous fracture, 2.29 (95%CI 1.56-3.34); and a fall in the last 12 months, 1.60 (95%CI 1.10-2.31). Being a current smoker was not associated with an increase in risk, and was consistent across all fracture types.


DISCUSSION
Older women with the clinical risk factors identified in this study should be investigated for osteoporosis or offered preventive treatment.