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

Arch Phys Med Rehabil. 2002 Jul;83(7):903-6. doi: 10.1053/apmr.2002.33111.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon
  • Accidental Falls / statistics & numerical data*
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Bone Density
  • Bone Diseases, Metabolic / diagnostic imaging
  • Bone Diseases, Metabolic / epidemiology
  • Comorbidity
  • Female
  • Fractures, Bone / diagnostic imaging
  • Fractures, Bone / epidemiology*
  • Humans
  • Middle Aged
  • Odds Ratio
  • Osteoporosis / diagnostic imaging
  • Osteoporosis / epidemiology*
  • Postmenopause*
  • Prevalence
  • Retrospective Studies
  • Risk Assessment