Clinical risk factors for fracture in postmenopausal Canadian women: a population-based prevalence study

Clinical risk factor assessment can be used to enhance fracture risk estimation based upon bone densitometry alone. Population- and age-specific risk factor prevalence data are required for the construction of these risk models. Our objective was to derive population-based prevalence estimates of specific clinical risk factors for postmenopausal women resident in the Province of Manitoba, Canada. A random sample of 40,300 women age 50 or older identified from the provincial health plan was mailed a validated self-report risk factor survey. The response rate was 8747 (21.7%) with a final study population of 8027 women after exclusions. The individual prevalence for each clinical risk factor ranged from 5.8% for hyperthyroidism to 33.0% for a fall in the preceding 12 months. Most point prevalence estimates were similar to other large cohort studies, though the prevalences of inactivity and poor mobility were higher than expected while height at age 25 and the prevalence of any fracture after age 50 were lower than expected. Most of the respondents (86.9%) had at least one non-age clinical risk factor, 60.6% had two or more, and 33.5% had three or more. Age affected risk factor prevalence, and older age was associated with a higher rate of multiple risk factors. The availability of age-specific risk factor prevalence rates in this population may allow for more accurate fracture risk modeling.