Abstract
There is important geographic variation in the occurrence of the major osteoporotic fractures across Europe. The aim of this study was to determine whether between-center variation in limb fracture rates across Europe could be explained by variation in the incidence of falls. Men and women, aged 50-79 years, were recruited from population-based registers in 30 European centers. Subjects were followed by postal questionnaire to ascertain the occurrence of incident fractures, and were also asked about the occurrence and number of recent falls. Self-reported fractures were confirmed, where possible, by review of the radiographs, medical record, or subject interview. The age- and gender-adjusted incidence of falls was calculated by center using Poisson regression. Poisson regression was also used to assess the extent to which between-center differences in the incidence of limb fractures could be explained by differences in the age- and gender-adjusted incidence of falls at those centers. In all, 6302 men (mean age 63.9 years) and 6761 women (mean age 63.1 years) completed at least one questionnaire concerning fractures and falls. During a median follow-up time of 3 years, 3647 falls were reported by men and 4783 by women. After adjusting for age and gender, there was evidence of significant between-center differences in the occurrence of falls. There was also between-center variation in the occurrence of upper limb, lower limb, and distal forearm fractures. Variation in the age- and gender-adjusted center-specific fall rates explained 24%, 14%, and 6% of the between-center variation in incidence of distal forearm and upper and lower limb fractures, respectively. Given the constraints inherent in such an analysis, in men and women aged 50-79 years, variation in fall rates could explain a significant proportion of the between-center variation in the incidence of limb fracture across Europe.
| Original language | English |
|---|---|
| Journal | Bone |
| Volume | 31 |
| Issue number | 6 |
| Pages (from-to) | 712-717 |
| Number of pages | 6 |
| ISSN | 8756-3282 |
| DOIs | |
| Publication status | Published - 01.12.2002 |
Funding
This study was financially supported by a European Union Concerted Action Grant under Biomed-1 (BMH1CT920182), and also EU Grants C1PDCT925102, ERBC1PDCT 930105, and 940229. The central coordination was also supported by the UK Arthritis Research Campaign, the Medical Research Council (G9321536), and the European Foundation for Osteoporosis and Bone Disease. The EU’s PECO program linked to Biomed-1 funded in part the participation of the Budapest, Warsaw, Prague, Piestany, Szczecin, and Moscow centers. Data collection from Croatia was supported by a grant from the Wellcome Trust. Individual centers acknowledge the receipt of locally obtained support for their data collection. The authors thank the following individuals: Rita Smith, Aberdeen, UK; Uday Bhonsle, Anna Martin, Judith Walton, and Bridget Wardley-Smith, Cambridge and Harrow, UK; Joanna Parsons, Truro, UK; and Manuel Naves Diaz, J. Bernardino Diaz Lopez, and Ana Rodriguez Rebollar, Oviedo, Spain. We also thank the individuals who took part in the study and the many others who helped access our population samples.
