Fracture Risk Factors in Community-Dwelling Older Adults: Insights from the Canadian Longitudinal Study on Aging
Bibliographic record
Abstract
Objectives: This study aimed to investigate whether new potential risk factors (cognition, frailty, falls, social isolation/loneliness, and osteosarcopenia), not included in traditional fracture risk prediction models, are associated with fracture risk in community-dwelling older adults. Methods: Participants aged 65 years or older from the Canadian Longitudinal Study on Aging (CLSA) who completed the 2015 baseline and 2018 follow-up assessments were included. The outcome was self-reported fractures in the 12 months prior to both baseline and a three-year follow-up. Baseline predictor variables included cognition variables (memory, executive function, and psychomotor speed), frailty (assessed using the Rockwood Frailty Index), falls (assessed as occurrence at the 12 months prior to baseline), social isolation/loneliness (assessed using the CLSA-Social Isolation Index), and osteosarcopenia defined as a combination of osteopenia/osteoporosis (bone mineral density femoral neck T-score <-1) and sarcopenia (grip strength <35.5 kg for males and <16kg for females, as well as gait speed <0.8 m/s for both sexes). Findings: When considering cognition, frailty, and falls simultaneously, the frailty index was independently associated with fracture risk [adjusted odd ratio (OR) 1.44, 95% confidence interval (CI) 1.11-1.52 per each standard deviation (SD) increment in the frailty index]. The Social Isolation Index was associated with fracture risk (adjusted OR 1.13, 95% CI 1.01-1.27); however, this association was dependent on an interaction with depressive symptoms. In males, osteosarcopenia was associated with a 2.6-fold higher fracture risk compared to those with normal bone density without sarcopenia (adjusted OR 2.60, 95% CI 1.14-5.91). Conclusion: Frailty, social isolation/loneliness, and osteosarcopenia are associated with fracture risk in Canadian community-dwelling older adults aged 65 years or older. These new risk factors may be used in the future to develop better fracture prediction assessments.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".