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Past falls ‘independently help predict risk of bone fracture’

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A patient’s history of past falls can help predict their risk of bone fractures, independent of bone mineral density and other clinical factors, according to researchers.

The findings “clearly confirm” the value of falls in fracture risk assessment, said the study authors from the UK, Sweden, Hong Kong and the US.

“These new findings inform approaches to clinical fracture risk assessment”

Nicholas Harvey

The researchers used data from the Osteoporotic Fractures in Men (MrOS) study. It involved 4,365 men in the US, 1,823 in Sweden, and 1,669 in Hong Kong, with an average age ranging from 72.4 to 75.4 years, and average follow-up time from 8.7 to 10.8 years.

Rates of past falls were similar at 20%, 16%, and 15% respectively. Rates of previous fracture were higher in Sweden (33%) than in the US (22%) and Hong Kong (13%).

Even after accounting for results from the Fracture Risk Assessment Tool (FRAX) and/or bone mineral density tests, past falls were linked with a 63-71% increased risk of a new fracture occurring.

The “predictive value of past falls for future fracture was well established”, noted the researchers in the Journal of Bone and Mineral Research.

However, they said their study provided the first evidence from a large population study that it was a risk factor independent of FRAX with or without bone mineral density.

“We have demonstrated that previous falls and high FRAX probability independently predict the risk of future fracture,” said the study authors.

“These findings support the notion that consideration of falls history is likely to add usefully to risk assessment based on the FRAX tool and as such will be of relevance to a large number of guidelines globally,” they added.

Lead author Professor Nicholas Harvey, from Southampton University, said: “Whilst the predictive value of falls for future fracture is well-established, these new findings inform approaches to clinical fracture risk assessment.”

It demonstrates that the “fracture risk associated with prior falls is relevant over and above the risk identified by the current global standard approach of FRAX and bone mineral density”, he stated.


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