Poster Presentation 1st Asia Pacific Herbert Fleisch Workshop 2025

Incidence of vertebral fracture in a cohort of Australian women: Data from the Geelong Osteoporosis Study (#113)

Kara B Anderson 1 , Amelia G Morse 1 , Amanda L Stuart 1 , Julie A Pasco 1 2 3 4 , Mark A Kotowicz 1 2 4 , Kara L Holloway-Kew 1
  1. IMPACT (Institute for Mental and Physical Health and Clinical Translation), School of Medicine, Deakin University, Geelong
  2. Barwon Health, Geelong, Victoria, Australia
  3. Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
  4. Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia

Purpose

Vertebral fractures are a common outcome of osteoporosis, yet these skeletal injuries are often asymptomatic and go undiagnosed. Studies to assess the rate of incident fracture are often limited by their study design (e.g. clinical trials with strict inclusion and exclusion criteria, opportunistic clinical samples). This study aimed to assess the incidence of vertebral fracture in a representative cohort of Australian women.

Methods

Lateral vertebral assessment (Lunar Prodigy) was obtained at two time points for participants of the Geelong Osteoporosis Study. Incident vertebral fractures were defined by the software according to Genant semi-quantitative criteria where the fracture was new at follow-up. Baseline characteristics, including age, height, weight and other clinical confounders, were compared between those with and without incident fracture. Incidence rate was calculated as number of participants with incident fracture over the total number of person-years (p-y) of observation, and subsequently age-standardised to the Australian population.

Results

Participants were 701 women (ages 21-86y), 19 of whom experienced an incident vertebral fracture. The standardised incidence rate was 6.78 (4.19-9.37) fractures per 1000p-y. Individuals who fractured were older (70.1 vs 48.7, p<0.001) and shorter (158.1 vs 163.0cm, p=0.001), than those who did not. They were more likely to be fallers (52.6% vs 24.5%, p=0.005), smokers (42.1% vs 12.8%, p<0.001), to have lower mobility (42.1% vs 13.5%, p<0.001), and have an existing vertebral fracture at baseline (10.5% vs 1.6%, p=0.005). They also had lower femoral neck bone mineral density (BMD) (p=0.001). No associations were observed between incident fracture and back pain (prevalent or onset), self-rated health or height loss at follow-up.

Conclusions

Incident fracture was associated with older age, shorter height, smoking, low mobility, and previous falls, as well as prior vertebral fracture and lower BMD, but not associated with back pain, self-rated health or height loss.