Shifting the focus in fracture prevention from osteoporosis to falls

Abstract

Preventing fractures in older people is important. But Teppo Järvinen and colleagues believe that we should be putting our efforts into stopping falls not treating low bone mineral density

Fig 1 Femoral neck bone mineral density versus age at time of fall in people who did and did not sustain a hip fracture. Dashed lines show 2 SD less than peak bone mass for women (lower line) and men (upper line). Adapted from Greenspan et al

Fig 2 Five year incidence of hip fracture in postmenopausal women by score on fracture index (based on age, previous fracture, mother’s hip fracture occurrence, weight, smoking, and ability to rise from a chair without hands). The two panels illustrate the marginal effect of including bone mineral density on the ability of the index to predict future hip fractures. The finding was similar in other fractures. Adapted from Black et al