Application of epidemiology to change health policy: Defining age-related thresholds of bone mineral density for primary prevention of fracture

Henry, Margaret J., Pasco, Julie A., Sanders, Kerrie M., Kotowicz, Mark A. and Nicholson, Geoffrey C. (2008) Application of epidemiology to change health policy: Defining age-related thresholds of bone mineral density for primary prevention of fracture. Journal of Clinical Densitometry, 11 4: 494-497. doi:10.1016/j.jocd.2008.05.090


Author Henry, Margaret J.
Pasco, Julie A.
Sanders, Kerrie M.
Kotowicz, Mark A.
Nicholson, Geoffrey C.
Title Application of epidemiology to change health policy: Defining age-related thresholds of bone mineral density for primary prevention of fracture
Journal name Journal of Clinical Densitometry   Check publisher's open access policy
ISSN 1094-6950
1559-0747
Publication date 2008-10-01
Year available 2008
Sub-type Article (original research)
DOI 10.1016/j.jocd.2008.05.090
Open Access Status Not yet assessed
Volume 11
Issue 4
Start page 494
End page 497
Total pages 4
Place of publication Amsterdam, Netherlands
Publisher Elsevier BV
Language eng
Abstract In Australia, benefits for antifracture therapies have been available for patients with osteoporosis and a prior fracture. No benefits were available to those with no prior fracture. We aimed to define, in women with no prior fracture, age-related thresholds of bone mineral density (BMD) associated with fracture risk equivalent to that of women with prior fracture and osteoporosis. A case-control study of women (≥50 yr) was conducted, including 291 fracture cases and 823 controls. BMD was measured at the proximal femur and posterior anterior (PA) spine. A fracture risk score (FRS) for the group with no prior fracture was calculated with discriminant analysis. The thresholds for equivalent fracture risk between those with no prior fracture and those with prior fracture were assessed using logistic regression. Increasing the FRS to +0.98 in women with no prior fracture resulted in equivalent odds of sustaining a fracture to those with prior fracture and osteoporosis. The corresponding T-score thresholds at the spine were −4.6 at 50 yr, −3.9 at 60 yr, −3.1 at 70 yr, and −2.4 at 80 yr. The femoral neck T-score thresholds were lower by 0.5 standard deviation. The high-risk individuals defined by this study should be considered for primary fracture prevention therapy.
Keyword Bone mineral density
Epidemiololoy
Fracture risk score
Health policy
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ
Additional Notes Issue: October-December 2008

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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