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Osteoporosis International
Published in: Osteoporosis International 4/2024

02-12-2023 | Osteoporosis | Original Article

Geographic variation in bone mineral density and prevalent fractures in the Canadian longitudinal study on aging

Authors: N. Hassanabadi, C. Berger, A. Papaioannou, A. M. Cheung, E. Rahme, W. D. Leslie, D. Goltzman, S. N. Morin

Published in: Osteoporosis International | Issue 4/2024

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Abstract

Summary

Awareness of the prevalence of osteoporosis and fractures across jurisdictions can guide the development of local preventive programs and healthcare policies. We observed geographical variations in total hip bone mineral density and in the prevalence of major osteoporotic fractures across Canadian provinces, which persisted after adjusting for important covariates.

Purpose

We aimed to describe sex-specific total hip bone mineral density (aBMD) and prevalent major osteoporotic fractures (MOF) variation between Canadian provinces.

Methods

We used baseline data from 21,227 Canadians (10,716 women, 10,511 men) aged 50–85 years in the Canadian Longitudinal Study on Aging (CLSA; baseline: 2012–2015). Linear and logistic regression models were used to examine associations between province of residence and total hip aBMD and self-reported MOF, stratified by sex. CLSA sampling weights were used to generate the prevalence and regression estimates.

Results

The mean (SD) age of participants was 63.9 (9.1) years. The mean body mass index (kg/m2) was lowest in British Columbia (27.4 [5.0]) and highest in Newfoundland and Labrador (28.8 [5.3]). Women and men from British Columbia had the lowest mean total hip aBMD and the lowest prevalence of MOF. Alberta had the highest proportion of participants reporting recent falls (12.0%), and Manitoba (8.4%) the fewest (p-value=0.002). Linear regression analyses demonstrated significant differences in total hip aBMD: women and men from British Columbia and Alberta, and women from Manitoba and Nova Scotia had lower adjusted total hip aBMD than Ontario (p-values<0.02). Adjusted odds ratios (95% confidence intervals, CI) for prevalent MOF were significantly lower in women from British Columbia (0.47 [95% CI: 0.32; 0.69]) and Quebec (0.68 [95% CI: 0.48; 0.97]) and in men from British Columbia (0.40 [95% CI:0.22; 0.71]) compared to Ontario (p-values<0.03). Results were similar when adjusting for physical performance measures and when restricting the analyses to participants who reported White race/ethnicity.

Conclusion

Geographical variations in total hip aBMD and in the prevalence of MOF between provinces persisted after adjusting for important covariates which suggests an association with unmeasured individual and environmental factors.
Appendix
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Metadata
Title
Geographic variation in bone mineral density and prevalent fractures in the Canadian longitudinal study on aging
Authors
N. Hassanabadi
C. Berger
A. Papaioannou
A. M. Cheung
E. Rahme
W. D. Leslie
D. Goltzman
S. N. Morin
Publication date
02-12-2023
Publisher
Springer London
Published in
Osteoporosis International / Issue 4/2024
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-023-06975-5

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