Spine Fracture Prevalence in US Women and Men Aged 40 years and older: Results from NHANES 2013-2014
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Spine Fracture Prevalence in US Women and Men Aged 40 years and older: Results from NHANES 2013-2014

Filetype[PDF-129.91 KB]

  • English

  • Details:

    • Alternative Title:
      Osteoporos Int
    • Description:

      Although spine fractures have important medical and prognostic significance, they are frequently unrecognized. According to the Surgeon General, more information about spine fracture epidemiology is needed.


      The primary objective was to determine prevalence of vertebral fractures by Vertebral Fracture Assessment (VFA) in men and women aged ≥40. Additional objectives included determining characteristics of those with vertebral fractures, comparing self-report versus VFA-diagnosed fracture, and assessing prevalence in those meeting National Osteoporosis Foundation (NOF) criteria for spine imaging.

      Design, Setting and Participants:

      Cross-sectional analysis of 3330 US adults aged ≥40 who participated in the National Health and Nutrition Examination Survey (NHANES) 2013-2014 and had evaluable VFA data.

      Main Outcome Measures:

      VFA graded by semi-quantitative measurement, bone mineral density (BMD) of lumbar spine (LS) and proximal femur, osteoporosis questionnaire.


      Overall prevalence of vertebral fractures was 5.4% and was similar in men and women. Prevalence increased with age (P < .01) from <5% in those <60 to 11% of those 70-79 and 18% of those ≥80. Fractures were more common in non-Hispanic whites, and in people with lower body mass index and lower BMD. Prevalence was higher in subjects who did versus did not meet selected NOF criteria for spine imaging (14% vs. 4.7%, P < .001). Among all subjects with vertebral fracture, 26% had osteoporosis at the LS or FN by BMD criteria. In those ≥65 with vertebral fracture, 38% had osteoporosis by at least one site, and only 22% were normal at both sites (compared to those without fracture where 14% had osteoporosis and 35% had normal BMD at both sites). Only 8% of people with a spine fracture by VFA had a self-reported fracture, and among those who self-reported a spine fracture, only 21% were diagnosed with fracture by VFA.


      Prevalence of vertebral fracture is similar in women and men and increases with age and lower BMD. Objective assessments with lateral spine imaging are critical for identifying subjects with vertebral fractures. The prevalence of vertebral fracture was three-fold higher in individuals who met NOF recommendations for targeted spine imaging

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