PMID- 32034452
OWN - NLM
STAT- MEDLINE
DCOM- 20210219
LR  - 20210219
IS  - 1433-2965 (Electronic)
IS  - 0937-941X (Linking)
VI  - 31
IP  - 6
DP  - 2020 Jun
TI  - Testing a theoretical model of imminent fracture risk in elderly women: an 
      observational cohort analysis of the Canadian Multicentre Osteoporosis Study.
PG  - 1145-1153
LID - 10.1007/s00198-020-05330-2 [doi]
AB  - We examined the underlying relationship between fracture risk factors and their 
      imminent risk. Results suggested that having past year fracture, worse past year 
      general health, worse past year physical functioning, and lower past year BMD 
      T-score directly predicted higher imminent fracture risk. Past year falls 
      indirectly predicted imminent risk through physical functioning and general 
      health. INTRODUCTION: This study aimed to examine direct and indirect effects of 
      several factors on imminent (1 year) fracture risk. METHODS: Data from women age 
      65 and older from population-based Canadian Multicentre Osteoporosis Study were 
      used. Predictors were identified from study years 5 and 10, and imminent fracture 
      data (1-year fracture) came from years 6 and 11 (year 5 predicts year 6, year 10 
      predicts year 11). A structural equation model (SEM) was used to test the 
      theoretical construct. General health and physical functioning were measured as 
      latent variables using items from the 36-Item Short Form Health Survey (SF-36) 
      and bone mineral density (BMD) T-score was a latent variable based on observed 
      site-specific BMD data (spine L1-L4, femoral neck, total hip). Observed variables 
      were fractures and falls. Model fit was evaluated using root mean square error of 
      approximation (RMSEA), Tucker Lewis index (TLI), and comparative fit index (CFI). 
      RESULTS: The analysis included 3298 women. Model fit tests showed that the SEM 
      fit the data well; chi(2)(172) = 1122.10 < .001, RMSEA = .03, TLI = .99, CFI = .99. 
      Results suggested that having past year fracture, worse past year general health, 
      worse past year physical functioning, and lower past year BMD T-score directly 
      predicted higher risk of fracture in the subsequent year (p < .001). Past year 
      falls had a statistically significant but indirect effect on imminent fracture 
      risk through physical functioning and general health (p < .001). CONCLUSIONS: We 
      found several direct and indirect pathways that predicted imminent fracture risk 
      in elderly women. Future studies should extend this work by developing risk 
      scoring methods and defining imminent risk thresholds.
FAU - Papaioannou, A
AU  - Papaioannou A
AD  - McMaster University, Hamilton, ON, Canada.
FAU - Adachi, J D
AU  - Adachi JD
AD  - McMaster University, Hamilton, ON, Canada.
FAU - Berger, C
AU  - Berger C
AD  - Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
FAU - Jiang, Y
AU  - Jiang Y
AUID- ORCID: 0000-0002-0498-0662
AD  - Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA, 91320, USA. 
      jiangyw26@mail.sysu.edu.cn.
FAU - Barron, R
AU  - Barron R
AD  - Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA, 91320, USA.
FAU - McGinley, J S
AU  - McGinley JS
AD  - Vector Psychometric Group, LLC, Chapel Hill, NC, USA.
FAU - Wirth, R J
AU  - Wirth RJ
AD  - Vector Psychometric Group, LLC, Chapel Hill, NC, USA.
FAU - Anastassiades, T P
AU  - Anastassiades TP
AD  - Queen's University, Kingston, ON, Canada.
FAU - Davison, K S
AU  - Davison KS
AD  - University of Victoria, Victoria, BC, Canada.
FAU - Hanley, D A
AU  - Hanley DA
AD  - Cumming School of Medicine, University of Calgary, Calgary, AL, Canada.
FAU - Ioannidis, G
AU  - Ioannidis G
AD  - McMaster University, Hamilton, ON, Canada.
FAU - Kaiser, S M
AU  - Kaiser SM
AD  - Dalhousie University, Halifax, NS, Canada.
FAU - Kovacs, C S
AU  - Kovacs CS
AD  - Memorial University of Newfoundland, St. John's, NL, Canada.
FAU - Leslie, W D
AU  - Leslie WD
AD  - University of Manitoba, Winnipeg, MB, Canada.
FAU - Morin, S N
AU  - Morin SN
AD  - McGill University, Montreal, QC, Canada.
FAU - Prior, J C
AU  - Prior JC
AD  - University of British Columbia, Vancouver, BC, Canada.
FAU - Towheed, T
AU  - Towheed T
AD  - Queen's University, Kingston, ON, Canada.
FAU - Goltzman, D
AU  - Goltzman D
AD  - McGill University, Montreal, QC, Canada.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20200207
PL  - England
TA  - Osteoporos Int
JT  - Osteoporosis international : a journal established as result of cooperation 
      between the European Foundation for Osteoporosis and the National Osteoporosis 
      Foundation of the USA
JID - 9100105
SB  - IM
MH  - Aged
MH  - *Bone Density
MH  - Canada/epidemiology
MH  - Cohort Studies
MH  - Female
MH  - Fractures, Bone/*epidemiology
MH  - Humans
MH  - Models, Theoretical
MH  - Osteoporosis/*epidemiology
MH  - Risk Factors
OTO - NOTNLM
OT  - CaMos
OT  - epidemiology
OT  - fracture risk
OT  - imminent
OT  - older women
OT  - osteoporosis
EDAT- 2020/02/09 06:00
MHDA- 2021/02/20 06:00
CRDT- 2020/02/09 06:00
PHST- 2019/01/22 00:00 [received]
PHST- 2020/02/03 00:00 [accepted]
PHST- 2020/02/09 06:00 [pubmed]
PHST- 2021/02/20 06:00 [medline]
PHST- 2020/02/09 06:00 [entrez]
AID - 10.1007/s00198-020-05330-2 [pii]
AID - 10.1007/s00198-020-05330-2 [doi]
PST - ppublish
SO  - Osteoporos Int. 2020 Jun;31(6):1145-1153. doi: 10.1007/s00198-020-05330-2. Epub 
      2020 Feb 7.