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To examine when, where and how fractures occur in postmenopausal women.We analyzed data from the Global Longitudinal Study of Osteoporosis in Women (GLOW), including women aged ≥55 years from the United States of America, Canada, Australia and seven European countries. Women completed questionnaires including fracture data at baseline and years 1, 2 and 3.Among 60,393 postmenopausal women, 4122 incident fractures were reported (86% non-hip, non-vertebral [NHNV], 8% presumably clinical vertebral and 6% hip). Hip fractures were more likely to occur in spring, with little seasonal variation for NHNV or spine fractures. Hip fractures occurred equally inside or outside the home, whereas 65% of NHNV fractures occurred outside and 61% of vertebral fractures occurred inside the home. Falls preceded 68-86% of NHNV and 68-83% of hip fractures among women aged ≤64 to ≥85 years, increasing with age. About 45% of vertebral fractures were associated with falls in all age groups except those ≥85 years, when only 24% occurred after falling.In this multi-national cohort, fractures occurred throughout the year, with only hip fracture having a seasonal variation, with a higher proportion in spring. Hip fractures occurred equally within and outside the home, spine fractures more often in the home, and NHNV fractures outside the home. Falls were a proximate cause of most hip and NHNV fractures. Postmenopausal women at risk for fracture need counseling about reducing potentially modifiable fracture risk factors, particularly falls both inside and outside the home and during all seasons of the year.

Original publication

DOI

10.1371/journal.pone.0083306

Type

Journal article

Journal

PloS one

Publication Date

01/2013

Volume

8

Addresses

Department of Medicine, Division of Endocrinology, College of Physicians and Surgeons, Columbia University, New York, United States of America ; Department of Medicine, Division of Endocrinology, São Paulo Federal University, São Paulo, Brazil.

Keywords

Humans, Osteoporosis, Postmenopausal, Hip Fractures, Retrospective Studies, Seasons, Accidental Falls, Age Factors, Aged, Aged, 80 and over, Middle Aged, Male