Predicting injuries in older women before they happen

A recent study into bone health has uncovered a previously overlooked piece of the puzzle when it comes to predicting fracture risks in women.   

Fractures are more common among older women compared to men, with 1 in 3 women and 1 in 5 men, over the age of 50 years experiencing an osteoporosis fracture during their lifetime 

Currently, doctors can measure a patient’s risk of experiencing a fracture by completing a bone density scan of the hip and spine. But sometimes this isn’t possible, Dr Kara Holloway-Kew explains.   

Dr Holloway-Kew is a Senior Research Fellow with IMPACT’s Population Health theme and explains how important this area of research is, especially given Australia’s ageing population. 

‘Being able to predict a patient’s risk of fracture is extremely important, particularly in female populations who are more prone to poor bone health which can lead to fracture. After menopause, the amount of bone in the skeleton decreases dramatically. This is due to reductions in hormone levels, which are important for maintaining bone health,’ Dr Holloway-Kew says.  

‘Sometimes patients have a hip replacement, prior fractures or degeneration in the spine, and in this case, a scan of the mid-forearm is recommended. However, scans of the wrist are not used to predict fracture risk, even if they are available.

‘Experiencing a fracture can affect a patient’s quality of life and ability to function independently, and this is why practitioners need to predict which individuals are at the highest risk and provide anti-fracture treatments.’

– Dr Kara Holloway-Kew

A local study providing global research findings

The Geelong Osteoporosis Study (GOS) is a world-renowned study that has been running for 30 years and followed the lives of over 1,400 women providing valuable findings from everything from osteoporosis to mental health conditions.    

Dr Kara Holloway-Kew recently published an article titled ‘Associations between ultra-distal forearm bone mineral density and incident fracture in women’ in Osteoporosis International which suggests improved ways of predicting fractures in female patients.  

Finding new answers for patients 

Dr Holloway-Kew explains that this is a limited area of research and finding new options for patients is central to her research.  

‘Our research was not only able to prove that we can use bone density scans of the wrist to predict fractures, but these scans performed just as well as other measurements of the hip, spine and mid-forearm to predict any future fracture,’ she says. 

‘Previously scans of the wrist were ignored for a long time, and they weren’t used in fracture risk predictions. 

 ‘Patients who cannot have scans of the hip or spine performed, or who are worried about radiation can have a scan of the wrist instead, which may provide useful information for fracture risk predictions.  

‘We even found that these scans worked as a better predictor of fractures of the wrist and outperformed the risk calculations by the routinely used Fracture Risk Calculator (FRAX). 

‘This could influence the way we predict future fracture risk by providing additional information to doctors, allowing better clinical decisions to be made for patients who may not be able to have scans of the hip or spine performed. 

‘Additionally, for patients where the hip or spine scans do not give a clear indication of risk (e.g. they are “borderline”) then additional information from the wrist scan may help make a decision.’ 

Interested in this research? Find out more about IMPACT’s Population Health theme here and follow Dr Kara Holloway-Kew on LinkedIn here.