Predicting short-term refracture risk in older Canadian adults using CLSA DXA and clinical data

Project Summary

Osteoporotic fractures are common, costly, and often repeat: nearly half of second fractures occur within two years of the first. This near-term period is critical because repeat fractures drive loss of independence, disability, and health system costs. Current tools such as FRAX estimate 10-year probabilities and do not identify those at highest immediate risk. The Canadian Longitudinal Study on Aging (CLSA) follows >50,000 adults with repeated measures of bone density, medications, comorbidities, falls, and physical function. Using these routinely collected variables, we will develop and validate models that estimate the chance of a second fracture in the 12 months before the next CLSA visit (approximately 24-36 months after the index visit); in a subset with health-system linkage we will also report 12- and 24-month risks. These tools can support timely osteoporosis therapy and fall prevention, with the goal of reducing repeat fractures, preserving independence, and lowering costs.