Fracture Risk Scores Using Output from an Opportunistic Screen of Low Bone Density from Conventional X-ray.

Fracture risk is commonly assessed by FRAX, a tool that estimates 10-year risk for major osteoporotic fracture (MOF) and hip fracture. FRAX scores are often refined by additionally including femoral neck (FN) bone mineral density (BMD) measured by dual-energy x-ray absorptiometry (DXA) as an input. Rho™, a novel AI-powered software, estimates FN BMD T-Scores from conventional x-rays, even when FN is not in the image.

Virtual Intervention for Vertebral frActures (VIVA): protocol for a feasibility study of a multicentre randomized controlled trial.

Background: Vertebral fractures due to osteoporosis cause significant pain and disability. There is guidance available on the management of osteoporotic vertebral fractures, informed by systematic reviews and a consensus process. However, few studies examine whether implementing pragmatic and patient-oriented rehabilitation interventions can improve outcomes for individuals with a vertebral fracture.

Osteoporosis: A Review.

Importance: Osteoporosis is characterized by low bone mass, increased bone fragility, and increased susceptibility to fracture, which is associated with substantial morbidity, mortality, and economic costs. Worldwide, 1 in 3 women and 1 in 5 men older than 50 years of age experience osteoporotic fractures in their lifetime.

Observations: Risk factors for osteoporosis include older age, female sex, prior fractures, prior falls, low body weight, history of hip fracture in a parent, glucocorticoid use, cigarette smoking, excess alcohol consumption, certain comorbidities (eg, inflammatory bowel disease, rheumatoid arthritis, and chronic liver and kidney disease), and low level of bone mineral density (BMD; measured by dual-energy x-ray absorptiometry).

Step-Count Distribution as an Indicator of Walking Reserve in People with Gait Vulnerabilities.

Background: Steps per day can provide a lot of information about the activity of the average person whose main source of activity is derived from walking. This study looks at the distribution of step-count data to identify different subgroups of people which could be used to indicate walking reserve.

Methods: A time series design of a secondary data analysis was conducted to track the variability of daily step count for 44 seniors post-fracture.

Cross-sectional and longitudinal associations between statin use and bone density: the Manitoba BMD registry.

Statins are among the most widely prescribed medications in older individuals. Inconsistent data in humans suggest that statin medications may be associated with greater BMD and lower risk for osteoporosis. We identified 22 393 individuals aged 40 yr and older undergoing initial (Visit 1) and repeat (Visit 2) TH BMD measurement within 1-10 yr total from DXA through the Manitoba BMD Program (February 28, 1999 to March 29, 2018).

Antiresorptive Therapy to Reduce Fracture Risk and Effects on Dental Implant Outcomes in Patients With Osteoporosis: A Systematic Review and Osteonecrosis of the Jaw Taskforce Consensus Statement.

Objective: Placement of a dental implant in a patient on antiresorptive therapy has been hypothesized to increase the risk of medication-related osteonecrosis of the jaw (MRONJ) and/or impact implant survival. In patients with osteoporosis, the risk of MRONJ with antiresorptive therapy is only marginally higher than observed in the general population.

Methods: The International ONJ Taskforce conducted a systematic review of the literature and evaluated the outcomes of implant placement in individuals with osteoporosis receiving antiresorptive therapy.

Fracture Risk Assessment in the 2023 Osteoporosis Canada Guideline.

Radiologists and other diagnostic imaging specialists play a pivotal role in the management of osteoporosis, a highly prevalent condition of reduced bone strength and increased fracture risk. Bone mineral density (BMD) measurement with dual-energy X-ray absorptiometry (DXA) is a critical component of identifying individuals at high risk for fracture. Strategies to prevent fractures are consolidated in the Osteoporosis Canada clinical practice guideline which was updated in 2023.

Age at First Fracture and Later Fracture Risk in Older Adults Undergoing Osteoporosis Assessment.

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.

FRAX predicts cardiovascular risk in women undergoing osteoporosis screening: the Manitoba bone mineral density registry.

Osteoporosis and cardiovascular disease (CVD) are highly prevalent in older women, with increasing evidence for shared risk factors and pathogenesis. Although FRAX was developed for the assessment of fracture risk, we hypothesized that it might also provide information on CVD risk. To test the ability of the FRAX tool and FRAX-defined risk factors to predict incident CVD in women undergoing osteoporosis screening with DXA, we performed a retrospective prognostic cohort study which included women aged 50 yr or older with a baseline DXA scan in the Manitoba Bone Mineral Density Registry between March 31, 1999 and March 31, 2018.

Advanced glycation end products are not associated with bone mineral density, trabecular bone score, and bone turnover markers in adults with and without type 1 diabetes: a cross-sectional study.

It is unclear if AGEs are involved in the bone fragility of type 1 diabetes (T1D). We evaluated whether skin AGEs by skin autofluorescence and serum AGEs (pentosidine, carboxymethyl-lysine [CML]) are independently associated with BMD by DXA (lumbar spine, hip, distal radius), trabecular bone score (TBS), serum bone turnover markers (BTMs: CTX; P1NP; osteocalcin), and sclerostin in participants with and without T1D. Linear regression models were used, with interaction terms to test effect modification by T1D status.

Perspectives of wheelchair users with chronic spinal cord injury following a walking program using a wearable robotic exoskeleton.

Purpose: To examine the perspectives of wheelchair users with spinal cord injury (WU) regarding their participation in a 16-week walking program using a wearable robotic exoskeleton (WRE); and explore concerns and expectations regarding potential use of this device and intervention in the context of a home or community-based adapted physical activity program.

Method: Semi-structured interviews were conducted using a narrative research, 3 weeks post-intervention. Thematic analysis resulted in 6 themes and 21 subthemes.

Clinical practice guideline for management of osteoporosis and fracture prevention in Canada: 2023 update.

Background: In Canada, more than 2 million people live with osteoporosis, a disease that increases the risk for fractures, which result in excess mortality and morbidity, decreased quality of life and loss of autonomy. This guideline update is intended to assist Canadian health care professionals in the delivery of care to optimize skeletal health and prevent fractures in postmenopausal females and in males aged 50 years and older.

Methods: This guideline is an update of the 2010 Osteoporosis Canada clinical practice guideline on the diagnosis and management of osteoporosis in Canada.

What Do Older Canadians Think They Need to Walk Well?

Purpose: To identify older Canadians' perception of the importance of expert-generated elements of walking quality, and the contributors to and consequences of perceived walking quality.

Method: Cross-sectional survey of 649 adults was conducted through a commercial participant panel, Hosted in Canada Surveys.

Results: Of the 649 respondents, 75% were between 65 and 74 years old (25% ≥ 75) and 49% were women.

Adjusting FRAX Estimates of Fracture Probability Based on a Positive Vertebral Fracture Assessment.

Importance: FRAX is the most widely used and validated fracture risk prediction tool worldwide. Vertebral fractures, which are an indicator of subsequent osteoporotic fractures, can be identified using dual-energy x-ray absorptiometry (DXA) vertebral fracture assessment (VFA).

Objective: To assess the calibration of FRAX and develop a simple method for improving FRAX-predicted fracture probability in the presence of VFA-identified fracture.

Development, Acceptability, and Usability of a Virtual Intervention for Vertebral Fractures.

Objective: This project aimed to develop a virtual intervention for vertebral fractures (VIVA) to implement the international recommendations for the nonpharmacological management of osteoporotic vertebral fractures and to test its acceptability and usability.

Methods: VIVA was developed in accordance with integrated knowledge translation principles and was informed by the Behavioral Change Wheel, the Theoretical Domains Framework, and the affordability, practicability, effectiveness and cost-effectiveness, acceptability, side effects/safety, and equity (APEASE) criteria. The development of the prototype of VIVA involved 3 steps: understanding target behaviors, identifying intervention options, and identifying content and implementation options.

Non-pharmacological management of osteoporotic vertebral fractures: health-care professional perspectives and experiences.

Purpose: To understand experiences and perceptions on non-pharmacological treatment of vertebral fractures and virtual-care from the perspective of care professionals' (HCPs).

Design And Setting: We conducted semi-structured interviews with 13 HCPs within Canada (7 F, 6 M, aged 46 ± 12 years) and performed a thematic and content analysis from a post-positivism perspective.

Results: Two themes were identified: acuity matters when selecting appropriate interventions; and roadblocks to receiving non-pharmacological interventions.