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

Liesbeth Vandenput¹, Helena Johansson^{1

2

3}, Eugene V McCloskey^{2

4}, Enwu Liu¹, Marian Schini⁵, Kristina E Åkesson^{6

7}, Fred A Anderson⁸, Rafael Azagra^{9

10

11

12}, Cecilie L Bager¹³, Charlotte Beaudart^{14

15}, Heike A Bischoff-Ferrari^{16

17}, Emmanuel Biver¹⁸, Olivier Bruyère¹⁴, Jane A Cauley¹⁹, Jacqueline R Center^{20

21

22}, Roland Chapurlat²³, Claus Christiansen¹³, Cyrus Cooper^{24

25

26}, Carolyn J Crandall²⁷, Steven R Cummings²⁸, José A P da Silva^{29

30}, Bess Dawson-Hughes³¹, Adolfo Diez-Perez³², Alyssa B Dufour^{33

34}, John A Eisman^{20

21

22}, Petra J M Elders³⁵, Serge Ferrari¹⁸, Yuki Fujita³⁶, Saeko Fujiwara³⁷, Claus-Christian Glüer³⁸, Inbal Goldshtein^{39

40}, David Goltzman⁴¹, Vilmundur Gudnason^{42

43}, Jill Hall⁴⁴, Didier Hans⁴⁵, Mari Hoff^{46

47}, Rosemary J Hollick⁴⁸, Martijn Huisman^{49

50}, Masayuki Iki⁵¹, Sophia Ish-Shalom⁵², Graeme Jones⁵³, Magnus K Karlsson^{6

54}, Sundeep Khosla⁵⁵, Douglas P Kiel^{34

56}, Woon-Puay Koh^{57

58}, Fjorda Koromani^{59

60}, Mark A Kotowicz^{61

62

63}, Heikki Kröger^{64

65}, Timothy Kwok^{66

67}, Olivier Lamy^{68

69}, Arnulf Langhammer⁷⁰, Bagher Larijani⁷¹, Kurt Lippuner⁷², Fiona E A McGuigan⁶, Dan Mellström^{73

74}, Thomas Merlijn³⁵, Tuan V Nguyen^{22

75

76}, Anna Nordström^{77

78

79}, Peter Nordström⁸⁰, Terence W O'Neill^{81

82}, Barbara Obermayer-Pietsch^{83

84}, Claes Ohlsson^{3

85}, Eric S Orwoll⁸⁶, Julie A Pasco^{61

62

63

87}, Fernando Rivadeneira⁵⁹, Anne-Marie Schott⁸⁸, Eric J Shiroma⁸⁹, Kristin Siggeirsdottir^{42

90}, Eleanor M Simonsick⁹¹, Elisabeth Sornay-Rendu²³, Reijo Sund⁶⁵, Karin M A Swart^{92

93}, Pawel Szulc²³, Junko Tamaki⁹⁴, David J Torgerson⁹⁵, Natasja M van Schoor⁴⁹, Tjeerd P van Staa⁹⁶, Joan Vila⁹⁷, Nicholas J Wareham⁹⁸, Nicole C Wright⁹⁹, Noriko Yoshimura¹⁰⁰, MCarola Zillikens⁵⁹, Marta Zwart^{12

101

102

103}, Nicholas C Harvey^{24

25}, Mattias Lorentzon^{1

3

104}, William D Leslie¹⁰⁵, John A Kanis^{106

107}

Affiliations

¹ Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
² Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK.
³ Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁴ MRC and Arthritis Research UK Centre for Integrated Research in Musculoskeletal Ageing, Mellanby Centre for Musculoskeletal Research, University of Sheffield, Sheffield, UK.
⁵ Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK.
⁶ Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden.
⁷ Department of Orthopedics, Skåne University Hospital, Malmö, Sweden.
⁸ GLOW Coordinating Center, Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA.
⁹ Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain.
¹⁰ Health Centre Badia del Valles, Catalan Institute of Health, Barcelona, Spain.
¹¹ GROIMAP (Research Group), Unitat de Suport a La Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Cerdanyola del Vallès, Barcelona, Spain.
¹² PRECIOSA-Fundación Para La Investigación, Barberà del Vallés, Barcelona, Spain.
¹³ Nordic Bioscience A/S, Herlev, Denmark.
¹⁴ WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.
¹⁵ Department of Health Services Research, University of Maastricht, Maastricht, The Netherlands.
¹⁶ Department of Aging Medicine and Aging Research, University Hospital, Zurich, and University of Zurich, Zurich, Switzerland.
¹⁷ Centre On Aging and Mobility, University of Zurich and City Hospital, Zurich, Switzerland.
¹⁸ Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
¹⁹ Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
²⁰ Skeletal Diseases Program, Garvan Institute of Medical Research, Sydney, NSW, Australia.
²¹ St Vincent's Clinical School, School of Medicine and Health, University of New South Wales Sydney, Sydney, NSW, Australia.
²² School of Medicine Sydney, University of Notre Dame Australia, Sydney, NSW, Australia.
²³ INSERM UMR 1033, Université Claude Bernard-Lyon1, Hôpital Edouard Herriot, Lyon, France.
²⁴ MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.
²⁵ NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK.
²⁶ NIHR Oxford Biomedical Research Unit, University of Oxford, Oxford, UK.
²⁷ Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
²⁸ San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA, USA.
²⁹ Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
³⁰ Rheumatology Department, Centro Hospitalar E Universitário de Coimbra, Coimbra, Portugal.
³¹ Bone Metabolism Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center On Aging, Tufts University, Boston, MA, USA.
³² Department of Internal Medicine, Hospital del Mar and CIBERFES, Autonomous University of Barcelona, Barcelona, Spain.
³³ Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA.
³⁴ Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
³⁵ Department of General Practice, Amsterdam UMC, Location AMC, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
³⁶ Center for Medical Education and Clinical Training, Kindai University Faculty of Medicine, Osaka, Japan.
³⁷ Department of Pharmacy, Yasuda Women's University, Hiroshima, Japan.
³⁸ Section Biomedical Imaging, Molecular Imaging North Competence Center, Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein Kiel, Kiel University, Kiel, Germany.
³⁹ Maccabitech Institute of Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel.
⁴⁰ Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
⁴¹ Department of Medicine, McGill University and McGill University Health Centre, Montreal, Canada.
⁴² Icelandic Heart Association, Kopavogur, Iceland.
⁴³ University of Iceland, Reykjavik, Iceland.
⁴⁴ MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK.
⁴⁵ Interdisciplinary Centre of Bone Diseases, Bone and Joint Department, Lausanne University Hospital (CHUV) & University of Lausanne, Lausanne, Switzerland.
⁴⁶ Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.
⁴⁷ Department of Rheumatology, St. Olavs Hospital, Trondheim, Norway.
⁴⁸ Aberdeen Centre for Arthritis and Musculoskeletal Health, Epidemiology Group, University of Aberdeen, Aberdeen, UK.
⁴⁹ Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.
⁵⁰ Department of Sociology, VU University, Amsterdam, The Netherlands.
⁵¹ Department of Public Health, Kindai University Faculty of Medicine, Osaka, Japan.
⁵² Endocrine Clinic, Elisha Hospital, Haifa, Israel.
⁵³ Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
⁵⁴ Department of Orthopaedics, Skåne University Hospital, Malmö, Sweden.
⁵⁵ Robert and Arlene Kogod Center On Aging and Division of Endocrinology, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, USA.
⁵⁶ Marcus Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA.
⁵⁷ Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
⁵⁸ Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Singapore.
⁵⁹ Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
⁶⁰ Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
⁶¹ IMPACT (Institute for Mental and Physical Health and Clinical Translation), Deakin University, Geelong, VIC, Australia.
⁶² Barwon Health, Geelong, VIC, Australia.
⁶³ Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC, Australia.
⁶⁴ Department of Orthopedics and Traumatology, Kuopio University Hospital, Kuopio, Finland.
⁶⁵ Kuopio Musculoskeletal Research Unit, University of Eastern Finland, Kuopio, Finland.
⁶⁶ Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
⁶⁷ Jockey Club Centre for Osteoporosis Care and Control, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
⁶⁸ Centre of Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland.
⁶⁹ Service of Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland.
⁷⁰ HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
⁷¹ Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁷² Department of Osteoporosis, Bern University Hospital, University of Bern, Bern, Switzerland.
⁷³ Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁷⁴ Geriatric Medicine, Sahlgrenska University Hospital Mölndal, Mölndal, Sweden.
⁷⁵ School of Biomedical Engineering, University of Technology Sydney, Sydney, Australia.
⁷⁶ School of Population Health, UNSW Medicine, UNSW Sydney, Kensington, Australia.
⁷⁷ School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
⁷⁸ Department of Health Sciences, Swedish Winter Sports Research Centre, Mid Sweden University, Östersund, Sweden.
⁷⁹ Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
⁸⁰ Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
⁸¹ National Institute for Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
⁸² Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester, UK.
⁸³ Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University Graz, Graz, Austria.
⁸⁴ Center for Biomarker Research in Medicine, Graz, Austria.
⁸⁵ Department of Drug Treatment, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden.
⁸⁶ Department of Medicine, Oregon Health and Science University, Portland, OR, USA.
⁸⁷ Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
⁸⁸ Université Claude Bernard Lyon 1, U INSERM 1290 RESHAPE, Lyon, France.
⁸⁹ Laboratory of Epidemiology and Population Sciences, National Institute On Aging, Baltimore, MD, USA.
⁹⁰ Janus Rehabilitation, Reykjavik, Iceland.
⁹¹ Translational Gerontology Branch, National Institute On Aging Intramural Research Program, Baltimore, MD, USA.
⁹² Department of General Practice, Amsterdam UMC, Location VUmc, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
⁹³ PHARMO Institute for Drug Outcomes Research, Utrecht, The Netherlands.
⁹⁴ Department of Hygiene and Public Health, Faculty of Medicine, Educational Foundation of Osaka Medical and Pharmaceutical University, Osaka, Japan.
⁹⁵ York Trials Unit, Department of Health Sciences, University of York, York, UK.
⁹⁶ Centre for Health Informatics, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK.
⁹⁷ Statistics Support Unit, Hospital del Mar Medical Research Institute, CIBER Epidemiology and Public Health (CIBERESP), Barcelona, Spain.
⁹⁸ MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
⁹⁹ Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
¹⁰⁰ Department of Preventive Medicine for Locomotive Organ Disorders, The University of Tokyo Hospital, Tokyo, Japan.
¹⁰¹ Health Center Can Gibert del Plà, Catalan Institute of Health, Girona, Spain.
¹⁰² Department of Medical Sciences, University of Girona, Girona, Spain.
¹⁰³ GROIMAP/GROICAP (Research Groups), Unitat de Suport a La Recerca Girona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Girona, Spain.
¹⁰⁴ Region Västra Götaland, Geriatric Medicine, Sahlgrenska University Hospital, Mölndal, Sweden.
¹⁰⁵ Department of Medicine, University of Manitoba, Winnipeg, MB, Canada.
¹⁰⁶ Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia. w.j.Pontefract@sheffield.ac.uk.
¹⁰⁷ Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK. w.j.Pontefract@sheffield.ac.uk.

PMID: 38228807
DOI: 10.1007/s00198-023-07012-1

Free article

Meta-Analysis

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

Liesbeth Vandenput et al. Osteoporos Int. 2024 Mar.

Free article

. 2024 Mar;35(3):469-494.

doi: 10.1007/s00198-023-07012-1. Epub 2024 Jan 17.

Authors

Affiliations

¹ Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
² Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK.
³ Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁴ MRC and Arthritis Research UK Centre for Integrated Research in Musculoskeletal Ageing, Mellanby Centre for Musculoskeletal Research, University of Sheffield, Sheffield, UK.
⁵ Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK.
⁶ Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden.
⁷ Department of Orthopedics, Skåne University Hospital, Malmö, Sweden.
⁸ GLOW Coordinating Center, Center for Outcomes Research, University of Massachusetts Medical School, Worcester, MA, USA.
⁹ Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain.
¹⁰ Health Centre Badia del Valles, Catalan Institute of Health, Barcelona, Spain.
¹¹ GROIMAP (Research Group), Unitat de Suport a La Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Cerdanyola del Vallès, Barcelona, Spain.
¹² PRECIOSA-Fundación Para La Investigación, Barberà del Vallés, Barcelona, Spain.
¹³ Nordic Bioscience A/S, Herlev, Denmark.
¹⁴ WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.
¹⁵ Department of Health Services Research, University of Maastricht, Maastricht, The Netherlands.
¹⁶ Department of Aging Medicine and Aging Research, University Hospital, Zurich, and University of Zurich, Zurich, Switzerland.
¹⁷ Centre On Aging and Mobility, University of Zurich and City Hospital, Zurich, Switzerland.
¹⁸ Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
¹⁹ Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
²⁰ Skeletal Diseases Program, Garvan Institute of Medical Research, Sydney, NSW, Australia.
²¹ St Vincent's Clinical School, School of Medicine and Health, University of New South Wales Sydney, Sydney, NSW, Australia.
²² School of Medicine Sydney, University of Notre Dame Australia, Sydney, NSW, Australia.
²³ INSERM UMR 1033, Université Claude Bernard-Lyon1, Hôpital Edouard Herriot, Lyon, France.
²⁴ MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.
²⁵ NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospitals Southampton NHS Foundation Trust, Southampton, UK.
²⁶ NIHR Oxford Biomedical Research Unit, University of Oxford, Oxford, UK.
²⁷ Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
²⁸ San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA, USA.
²⁹ Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
³⁰ Rheumatology Department, Centro Hospitalar E Universitário de Coimbra, Coimbra, Portugal.
³¹ Bone Metabolism Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center On Aging, Tufts University, Boston, MA, USA.
³² Department of Internal Medicine, Hospital del Mar and CIBERFES, Autonomous University of Barcelona, Barcelona, Spain.
³³ Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA.
³⁴ Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
³⁵ Department of General Practice, Amsterdam UMC, Location AMC, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
³⁶ Center for Medical Education and Clinical Training, Kindai University Faculty of Medicine, Osaka, Japan.
³⁷ Department of Pharmacy, Yasuda Women's University, Hiroshima, Japan.
³⁸ Section Biomedical Imaging, Molecular Imaging North Competence Center, Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein Kiel, Kiel University, Kiel, Germany.
³⁹ Maccabitech Institute of Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel.
⁴⁰ Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
⁴¹ Department of Medicine, McGill University and McGill University Health Centre, Montreal, Canada.
⁴² Icelandic Heart Association, Kopavogur, Iceland.
⁴³ University of Iceland, Reykjavik, Iceland.
⁴⁴ MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK.
⁴⁵ Interdisciplinary Centre of Bone Diseases, Bone and Joint Department, Lausanne University Hospital (CHUV) & University of Lausanne, Lausanne, Switzerland.
⁴⁶ Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.
⁴⁷ Department of Rheumatology, St. Olavs Hospital, Trondheim, Norway.
⁴⁸ Aberdeen Centre for Arthritis and Musculoskeletal Health, Epidemiology Group, University of Aberdeen, Aberdeen, UK.
⁴⁹ Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.
⁵⁰ Department of Sociology, VU University, Amsterdam, The Netherlands.
⁵¹ Department of Public Health, Kindai University Faculty of Medicine, Osaka, Japan.
⁵² Endocrine Clinic, Elisha Hospital, Haifa, Israel.
⁵³ Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
⁵⁴ Department of Orthopaedics, Skåne University Hospital, Malmö, Sweden.
⁵⁵ Robert and Arlene Kogod Center On Aging and Division of Endocrinology, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, USA.
⁵⁶ Marcus Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA.
⁵⁷ Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
⁵⁸ Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Singapore.
⁵⁹ Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
⁶⁰ Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
⁶¹ IMPACT (Institute for Mental and Physical Health and Clinical Translation), Deakin University, Geelong, VIC, Australia.
⁶² Barwon Health, Geelong, VIC, Australia.
⁶³ Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC, Australia.
⁶⁴ Department of Orthopedics and Traumatology, Kuopio University Hospital, Kuopio, Finland.
⁶⁵ Kuopio Musculoskeletal Research Unit, University of Eastern Finland, Kuopio, Finland.
⁶⁶ Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
⁶⁷ Jockey Club Centre for Osteoporosis Care and Control, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
⁶⁸ Centre of Bone Diseases, Lausanne University Hospital, Lausanne, Switzerland.
⁶⁹ Service of Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland.
⁷⁰ HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
⁷¹ Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁷² Department of Osteoporosis, Bern University Hospital, University of Bern, Bern, Switzerland.
⁷³ Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁷⁴ Geriatric Medicine, Sahlgrenska University Hospital Mölndal, Mölndal, Sweden.
⁷⁵ School of Biomedical Engineering, University of Technology Sydney, Sydney, Australia.
⁷⁶ School of Population Health, UNSW Medicine, UNSW Sydney, Kensington, Australia.
⁷⁷ School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
⁷⁸ Department of Health Sciences, Swedish Winter Sports Research Centre, Mid Sweden University, Östersund, Sweden.
⁷⁹ Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
⁸⁰ Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
⁸¹ National Institute for Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
⁸² Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester, UK.
⁸³ Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University Graz, Graz, Austria.
⁸⁴ Center for Biomarker Research in Medicine, Graz, Austria.
⁸⁵ Department of Drug Treatment, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden.
⁸⁶ Department of Medicine, Oregon Health and Science University, Portland, OR, USA.
⁸⁷ Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
⁸⁸ Université Claude Bernard Lyon 1, U INSERM 1290 RESHAPE, Lyon, France.
⁸⁹ Laboratory of Epidemiology and Population Sciences, National Institute On Aging, Baltimore, MD, USA.
⁹⁰ Janus Rehabilitation, Reykjavik, Iceland.
⁹¹ Translational Gerontology Branch, National Institute On Aging Intramural Research Program, Baltimore, MD, USA.
⁹² Department of General Practice, Amsterdam UMC, Location VUmc, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
⁹³ PHARMO Institute for Drug Outcomes Research, Utrecht, The Netherlands.
⁹⁴ Department of Hygiene and Public Health, Faculty of Medicine, Educational Foundation of Osaka Medical and Pharmaceutical University, Osaka, Japan.
⁹⁵ York Trials Unit, Department of Health Sciences, University of York, York, UK.
⁹⁶ Centre for Health Informatics, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK.
⁹⁷ Statistics Support Unit, Hospital del Mar Medical Research Institute, CIBER Epidemiology and Public Health (CIBERESP), Barcelona, Spain.
⁹⁸ MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
⁹⁹ Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
¹⁰⁰ Department of Preventive Medicine for Locomotive Organ Disorders, The University of Tokyo Hospital, Tokyo, Japan.
¹⁰¹ Health Center Can Gibert del Plà, Catalan Institute of Health, Girona, Spain.
¹⁰² Department of Medical Sciences, University of Girona, Girona, Spain.
¹⁰³ GROIMAP/GROICAP (Research Groups), Unitat de Suport a La Recerca Girona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol, Girona, Spain.
¹⁰⁴ Region Västra Götaland, Geriatric Medicine, Sahlgrenska University Hospital, Mölndal, Sweden.
¹⁰⁵ Department of Medicine, University of Manitoba, Winnipeg, MB, Canada.
¹⁰⁶ Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia. w.j.Pontefract@sheffield.ac.uk.
¹⁰⁷ Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK. w.j.Pontefract@sheffield.ac.uk.

PMID: 38228807
DOI: 10.1007/s00198-023-07012-1

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 906,359 women and men (66.9% 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 21.4% of individuals. During a follow-up of 9,102,207 person-years, 87,352 fractures occurred of which 19,509 were hip fractures. A previous fall was associated with a significantly increased risk of any clinical fracture both in women (hazard ratio (HR) 1.42, 95% confidence interval (CI) 1.33-1.51) and men (HR 1.53, 95% CI 1.41-1.67). 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 1.53 (95% CI 1.27-1.84) in men vs. HR 1.32 (95% CI 1.20-1.45) in women, P for interaction = 0.013). 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. 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.

Conclusions: 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.

Keywords: fracture risk; hip fracture; major osteoporotic fracture; meta-analysis; previous falls; risk factors.

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References

1. Morrison A, Fan T, Sen SS, Weisenfluh L (2013) Epidemiology of falls and osteoporotic fractures: a systematic review. ClinicoEcon Outcomes Res 5:9–18 - PubMed
1. Masud T, Morris RO (2001) Epidemiology of falls. Age Ageing 30(Suppl 4):3–7 - DOI - PubMed
1. Garnett MF, Weeks JD, Spencer MR (2022) Unintentional fall deaths among adults aged 65 and over: United States, 2020. NCHS Data Brief. Nov;(449):1–8
1. Henry MJ, Pasco JA, Merriman EN, Zhang Y, Sanders KM, Kotowicz MA (2011) Nicholson GC (2011) Fracture risk score and absolute risk of fracture. Radiology 259(2):495–501 - DOI - PubMed
1. Gardsell P, Johnell O, Nilsson BE, Nilsson JA (1989) The predictive value of fracture, disease, and falling tendency for fragility fractures in women. Calcif Tissue Int 45:327–330 - DOI - PubMed

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

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

Authors

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Abstract

References

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LinkOut - more resources

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Medical

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