Characterizing types and circumstances of fractures in the Canadian Multicentre Osteoporosis Study

Patients are concerned about which activities increase fracture risk and which are considered safe. Our study describes where, when, and how fractures occurred in Canadian adults followed over ten years. Falls are a leading cause of all fracture types in Canadian adults and should be prioritized in fracture prevention guidelines. Our study characterized the type and circumstances of fractures which occurred over 10 years during the Canadian Multicentre Osteoporosis Study. Details of incident fractures were recorded annually using questionnaires, and fractures were confirmed by X-ray. Medical and lifestyle history, including self-reported physical activity, was obtained by interview at baseline, year 5 and year 10. 9423 community-dwelling females and males aged ≥ 25 years were included. 1533 fractures were reported and confirmed (13% hip, 4% pelvic, 12% vertebral, and 71% other). Most fractures occurred in females (82%), those aged ≥ 50 years (93%), and those with a bone mineral density T-score ≤ -1.0 standard deviation (84%). Descriptive analyses revealed that 65% of all fractures and 39% of vertebral fractures occurred due to falls during daily activities. Sporting injuries accounted for 6% of all fractures. Many vertebral fractures occurred without fall or injury or due to other circumstances including lifting, bending, or carrying. Falls are a leading cause of all fracture types in Canadian adults. Guidelines to prevent fractures need to include strategies to reduce the risk of falls during activities of daily living.