Observational studyJAMA network open2024
Age at First Fracture and Later Fracture Risk in Older Adults Undergoing Osteoporosis Assessment.
Observational study in JAMA network open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A bibliometric analysis of acupuncture applied to primary osteoporosis.Frontiers in medicine · 2025Pooled it
- Exposure to Drugs Related to Injurious Falls Risk and to Bisphosphonates in Nursing Home Residents With Recent Fracture.Journal of the American Medical Directors Association · 2026Article
- Exercise is associated with attenuated aging-related osteoporosis through TMAO alpha Klotho inflammasome signaling.iScience · 2026Article
- Predictive Value of the CRP/Albumin Ratio in Mortality Prediction in Hip Fracture Surgery Patients Admitted to Intensive Care.Life (Basel, Switzerland) · 2026Article
- Bone health in gender-diverse individuals: current challenges and future directions.Hormones (Athens, Greece) · 2026Review
- Development and validation of an osteoporosis risk-assessment model for Chinese older adults: a large-scale retrospective study.BMC geriatrics · 2026Article
- Beyond postmenopausal osteoporosis: reply to comments by Ömer Faruk Öz.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- The recent progression of extracellular vesicles application in osteoporosis.Frontiers in pharmacology · 2026Review
- Osteoporotic fractures prediction in Chinese postmenopausal women: a machine learning-based multi-dimensional approach.Frontiers in endocrinology · 2026Article
- Osteoporosis and Fracture Risk in Ovarian Cancer: Beyond the Oncologic Burden.Diagnostics (Basel, Switzerland) · 2025Review
- Effects and Complications of Hip Arthroplasty After Failure of Internal Fixation in Stable and Unstable Intertrochanteric Femoral Fractures.Orthopaedic surgery · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
Importance: Fragility fractures are often defined as those that occur after a certain age (eg, 40-50 years). Whether fractures occurring in early adulthood are equally associated with future fractures is unclear. Objective: To examine whether the age at which a prior fracture occurred is associated with future fracture risk. Design, Setting, and Participants: This observational, population-based cohort study included individuals from the Manitoba Bone Mineral Density Registry with a first bone mineral density (BMD) measurement between January 1, 1996, and March 31, 2018, with and without prior fracture in adulthood. Data analysis was completed between April 1, and May 31, 2023. Exposure: Individuals with fractures before their first dual-energy x-ray absorptiometry were stratified by the age at first fracture (10-year intervals from 20-29 to ≥80 years of age). Main Outcomes and Measures: Incident fractures occurring after dual-energy x-ray absorptiometry (index date) and before March 31, 2021, were identified using linked provincial administrative health data. Results: The cohort included 88 696 individuals (80 066 [90.3%] female; mean [SD] age, 64.6 [11.0] years) with a mean (SD) femoral neck T score of -1.4 (1.0). A total of 21 105 individuals (23.8%) had sustained a prior fracture at a mean (SD) age of 57.7 (13.6) years (range, 20.0-102.4 years) at the time of first prior fracture. During a mean (SD) of 9.0 (5.5) years of follow-up, incident fractures occurred in 13 239 individuals (14.6%), including 12 425 osteoporotic fractures (14.0%), 9440 major osteoporotic fractures (MOFs) (10.6%), and 3068 hip fractures (3.5%). The sex- and age-adjusted hazard ratios for all incident fractures, osteoporotic fractures, and MOFs, according to age at first fracture, were all significantly elevated, with point estimates ranging from 1.55 (95% CI, 1.28-1.88) to 4.07 (95% CI, 2.99-5.52). After adjusting for the additional covariates, the effect estimates were similar and remained significantly elevated, with point estimates ranging from fully adjusted hazard ratios of 1.51 (95% CI, 1.42-1.60) to 2.12 (95% CI, 1.67-2.71) across age categories. Sensitivity analyses examining age at last prior fracture and in those with multiple prior fractures showed similar results. Conclusions and Relevance: In this cohort study, fractures in adulthood were associated with future fractures regardless of the age at which they occurred. Thus, fractures in early adulthood should not be excluded when assessing an individual's ongoing fracture risk.
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