When, Where and How Osteoporosis-Associated Fractures Occur: An Analysis from the Global Longitudinal Study of Osteoporosis in Women (GLOW)

Abstract

ObjectiveTo examine when, where and how fractures occur in postmenopausal women.MethodsWe analyzed data from the Global Longitudinal Study of Osteoporosis in Women (GLOW), including women aged ≥55 years from the United States of America, Canada, Australia and seven European countries. Women completed questionnaires including fracture data at baseline and years 1, 2 and 3.ResultsAmong 60,393 postmenopausal women, 4122 incident fractures were reported (86% non-hip, non-vertebral [NHNV], 8% presumably clinical vertebral and 6% hip). Hip fractures were more likely to occur in spring, with little seasonal variation for NHNV or spine fractures. Hip fractures occurred equally inside or outside the home, whereas 65% of NHNV fractures occurred outside and 61% of vertebral fractures occurred inside the home. Falls preceded 68–86% of NHNV and 68–83% of hip fractures among women aged ≤64 to ≥85 years, increasing with age. About 45% of vertebral fractures were associated with falls in all age groups except those ≥85 years, when only 24% occurred after falling.ConclusionIn this multi-national cohort, fractures occurred throughout the year, with only hip fracture having a seasonal variation, with a higher proportion in spring. Hip fractures occurred equally within and outside the home, spine fractures more often in the home, and NHNV fractures outside the home. Falls were a proximate cause of most hip and NHNV fractures. Postmenopausal women at risk for fracture need counseling about reducing potentially modifiable fracture risk factors, particularly falls both inside and outside the home and during all seasons of the year.

A Guide to Improving the Care of Patients with Fragility Fractures, Edition 2

“…Hip fractures occur equally inside or outside the home, whereas other fragility fractures occur somewhat more commonly outside the home. 6 Fractures occur throughout the year evenly with the exception of hip fractures that occur with a slightly higher likelihood in springtime. 6 It has been shown that most patients who sustain a fracture and are more than 65 years old have weakened bone quality from osteoporosis or osteopenia, conditions that are largely untreated and silent until a fracture occurs, although osteoporosis is the most common disease of the bone.…”

“…6 Fractures occur throughout the year evenly with the exception of hip fractures that occur with a slightly higher likelihood in springtime. 6 It has been shown that most patients who sustain a fracture and are more than 65 years old have weakened bone quality from osteoporosis or osteopenia, conditions that are largely untreated and silent until a fracture occurs, although osteoporosis is the most common disease of the bone. 7 Osteoporosis is a metabolic bone disease characterized by low bone mass and microarchitectural deterioration of bone tissue that results in increased bone fragility and a consequent increase in fracture risk.…”

From the Fall to the Theater - Early Acute Phase in Osteoporotic Hip Fractures

“…The effect of seasons on hip fracture is under debate. Despite studies reporting seasonal increases in hip fracture (7,17,18), constant seasonal variation was also reported (6). Our study was conducted throughout the year, and the number of fractures were highest in winter.…”

Physical Activity Level of Post-menopausal Women with Low Bone Mineral Density

“…Clinical presentation can be quite variable, ranging from asymptomatic bone loss to severe fractures (especially of the femur and radius) caused by falls. 1 Elderly people, particularly women after menopause, are at a greater risk of developing OP. 2 OP treatment includes correction of nutritional deficiencies, particularly of calcium and vitamin D, prescription of medicines 3 and physical exercise.…”