The relationship among history of falls, osteoporosis, and fractures in postmenopausal women.

OBJECTIVE

To study the relative contribution of osteoporosis and falls to the occurrence of symptomatic fractures in postmenopausal women.

DESIGN

Retrospective survey of current osteoporosis in relation to falls and fractures in the preceding year.

SETTING

Patients of general practitioners of the area around a Belgian university.

PARTICIPANTS

A total of 2649 consecutive postmenopausal women (mean age, 61y; range, 45-91y).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Current bone density measurements (single-photon absorptiometry in the forearm) were analyzed in relation to self-reported incidence of falls and fractures in the preceding year.

RESULTS

Osteoporosis was found in 15% of the patients, 19% reported 1 or more falls during the preceding year, and 1.8% had a fracture during the preceding year. The age-adjusted risk for a fracture in the past 12 months for a 1 standard deviation decrease in bone density was 1.9 (95% confidence interval [CI], 1.4-2.5; P<.01). Adjusted risk for age, bone density, and body mass index (BMI) for a fracture in the past 12 months in patients who reported a fall was 6.0 (95% CI, 3.1-11.5; P<.001). Compared with women without osteoporosis and without a fall, women with osteoporosis without a fall had an age- and BMI-adjusted fracture risk of 2.8 (95% CI, 0.6-12.8; P<.10), and women with osteoporosis and a fall had an adjusted-fracture risk of 24.8 (95% CI, 6.9-88.6; P<.0001).

CONCLUSIONS

Falls are a major contributing factor to the occurrence of symptomatic fractures in postmenopausal women, independent of and additive to the risk attributable to age and osteoporosis.