John H Krege, Xiaohai Wan, Brian C Lentle, Claudie Berger, Lisa Langsetmo, Jonathan D Adachi, Jerilynn C Prior, Alan Tenenhouse, Jacques P Brown, Nancy Kreiger, Wojciech P Olszynski, Robert G Josse, David Goltzman, David Goltzman, Nancy Kreiger, Alan Tenenhouse, Suzanne Godmaire, Silvia Dumont, Claudie Berger, Wei Zhou, Carol Joyce, Christopher Kovacs, Emma Sheppard, Susan Kirkland, Stephanie Kaiser, Barbara Stanfield, Jacques P Brown, Louis Bessette, Marc Gendreau, Tassos Anastassiades, Tanveer Towheed, Barbara Matthews, Bob Josse, Sophie Jamal, Tim Murray, Barbara Gardner-Bray, Jonathan D. Adachi, Alexandra Papaioannou, Laura Pickard, Wojciech P. Olszynski, K. Shawn Davison, Jola Thingvold, David A. Hanley, Jane Allan, Jerilynn C. Prior, Millan Patel, Yvette Vigna, Nerkeza Andjelic, Brian Lentle

Our purpose was to identify factors for a parsimonious fracture risk assessment model considering morphometric spine fracture status, femoral neck bone mineral density (BMD) and the World Health Organization (WHO) clinical risk factors. Using data from 2761 subjects from the Canadian Multicentre Osteoporosis Study (CaMos), a prospective, longitudinal cohort study of randomly selected community-dwelling men and women aged ⩾50 years, we previously reported that a logistic regression model considering age, BMD and spine fracture status provided as much predictive information as a model considering these factors plus the remaining WHO clinical risk factors. The current analysis assesses morphometric vertebral fracture and/or nonvertebral fragility fracture at 5 years using data from an additional 1964 CaMos subjects who have now completed 5 years of follow-up (total N=4725). Vertebral fractures were identified from lateral spine radiographs assessed using quantititative morphometry at baseline and end point. Nonvertebral fragility fractures were determined by questionnaire and confirmed using radiographs or medical records; fragility fracture was defined as occurring with minimal or no trauma. In this analysis, a model including age, BMD and spine fracture status provided a gradient of risk per s.d. (GR/s.d.) of 1.88 and captured most of the predictive information of a model including morphometric spine fracture status, BMD and all WHO clinical risk factors (GR/s.d. 1.92). For comparison, this model provided more information than a model considering BMD and the WHO clinical risk factors (GR/s.d. 1.74). These findings confirm the value of age, BMD and spine fracture status for predicting fracture risk.