Risk factors for non-vertebral fractures in community-dwelling elderly: a 10-year follow-up study in New Zealand
Abstract
This 10-year study of 5000 + adults aged 50–84 found 20% experienced non-vertebral fractures. Higher risk was linked to female sex, older age, European ethnicity, lower education, living alone, alcohol use, prior falls/fractures, osteoporosis, arthritis, and antidepressants. Targeting modifiable factors (living arrangements, alcohol, antidepressants) could reduce fracture burden cost-effectively in older adults. Although there has been extensive research on non-vertebral fractures, their risk factors remain incompletely understood. This study aimed to examine risk factors associated with non-vertebral fractures through a longitudinal examination of a community-dwelling cohort. This was a follow-up of participants recruited from family practices into a randomized trial of vitamin D supplementation and interviewed between 2011 and 2012, with follow-up until 2022. The outcome was the first non-vertebral fracture during the follow-up period, as identified from hospital events and insurance claims for fractures. Candidate risk factors were selected using a domain-based approach, and Cox models were employed to estimate adjusted hazard ratios (HRs). The analysis comprised 5108 participants aged 50–84 years. Of these, 83% were of European/other ethnicity. A substantial proportion reported living with non-family members or living alone (20.5%), engaging in daily drinking (21.6%), or using antidepressants (11.9%). Over a median 10-year follow-up, 1016 participants (20%) experienced…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 5,108 participants or records.
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