
Accumulating Fragility Fractures Associate with Worsening Physical Capability and Self-Rated Health in Postmenopausal Women: A 20-Year Cohort Study
References
- Anderson, S. A., Li X, Franklin, P., & Wixted, J. J. (2008). Ankle fractures in the elderly: initial and long-term outcomes. Foot Ankle Int, 29, 1184–1188. 10.3113/FAI.2008.1184
- Babatunde, O. O., Bucknall, M., Burton, C., Forsyth, J. J., Corp, N., Gwilym, S., et al. (2021). Long-term clinical and socio-economic outcomes following wrist fracture: a systematic review and meta-analysis. Osteoporosis International, 33(4), 753–782. 10.1007/S00198-021-06214-9
- Beckenkamp, P. R., Lin, C. W. C., Chagpar, S., Herbert, R. D., Van Der Ploeg, H. P., & Moseley, A. M. (2014). Prognosis of physical function following ankle fracture: a systematic review with meta-analysis. J Orthop Sports Phys Ther, 44, 841–851. 10.2519/JOSPT.2014.5199
- Dyer, S. M., Crotty, M., Fairhall, N., Magaziner, J., Beaupre, L. A., Cameron, I. D., et al. (2016). A critical review of the long-term disability outcomes following hip fracture. BMC Geriatr, 16. 10.1186/S12877-016-0332-0
- Egund, L., McGuigan, F. E., Egund, N., Besjakov, J., & Åkesson, K. E. (2020). Patient-related outcome, fracture displacement and bone mineral density following distal radius fracture in young and older men. BMC Musculoskelet Disord, 21,1–10. https://doi.org/10.1186/S12891-020-03843-9/TABLES/4
- Fischer, S., Kapinos, K. A., Mulcahy, A., Pinto, L., Hayden, O., & Barron, R. (2017). Estimating the long-term functional burden of osteoporosis-related fractures. Osteoporos Int, 28, 2843–2851. 10.1007/S00198-017-4110-4
- Hack, J., Buecking, B., Aigner, R., Oberkircher, L., Knauf, T., Ruchholtz, S., et al. (2019). What are the influencing factors in self-rated health status after hip fracture? A prospective study on 402 patients. Arch Osteoporos, 14. 10.1007/S11657-019-0642-X
- Haleem, S., Choudri, M. J., Kainth, G. S., & Parker, M. J. (2023). Mortality following hip fracture: Trends and geographical variations over the last SIXTY years. Injury, 54, 620–629. 10.1016/J.INJURY.2022.12.008
- Honkanen, K., Honkanen, R., Heikkinen, L., Kröger, H., & Saarikoski, S. (1999). Validity of Self-Reports of Fractures in Perimenopausal Women. Am J Epidemiol, 150, 511–516. 10.1093/OXFORDJOURNALS.AJE.A010040
- Huang, C., Ross, P. D., & Wasnich, R. D. (1996). Vertebral Fracture and Other Predictors of Physical Impairment and Health Care Utilization. Arch Intern Med, 156, 2469–2475. 10.1001/ARCHINTE.1996.00440200087011
- Johnell, O., & Kanis, J. A. (2006). An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int, 17, 1726–1733. 10.1007/S00198-006-0172-4
- Juopperi, S., Sund, R., Rikkonen, T., Kröger, H., & Sirola, J. (2021). Cardiovascular and musculoskeletal health disorders associate with greater decreases in physical capability in older women. BMC Musculoskelet Disord, 22. 10.1186/s12891-021-04056-4
- Kanis, J. A., Johansson, H., McCloskey, E. V., Liu, E., Åkesson, K. E., Anderson, F. A., et al. (2023). Previous fracture and subsequent fracture risk: a meta-analysis to update FRAX. Osteoporos Int, 34, 2027–2045. 10.1007/S00198-023-06870-Z
- Nissinen, T., Sund, R., Suoranta, S., Kröger, H., & Väänänen, S. P. (2023). Combining Register and Radiological Visits Data Allows to Reliably Identify Incident Wrist Fractures. Clin Epidemiol, 15, 1001–1008. 10.2147/CLEP.S421013
- Nissinen, T., Sund, R., Suoranta, S., Kröger, H., & Väänänen, S. P. (2025). Identifying proximal humerus fractures: an algorithmic approach using registers and radiological visit data. Osteoporosis International, 36, 645–651. https://doi.org/10.1007/S00198-025-07414-3/TABLES/1
- Ortona,
E.,
Pagano, M.
T.,
Capossela,
L., &
Malorni,
W.
(2023). The Role of Sex Differences in Bone
Health and Healing. Biology (Basel),
12,
993 . 10.3390/BIOLOGY12070993 - Paolucci, T., Saraceni, V. M., & Piccinini, G. (2016). Management of chronic pain in osteoporosis: Challenges and solutions. J Pain Res, 9, 177–186. 10.2147/JPR.S83574
- Pluskiewicz, W., Adamczyk, P., & Drozdzowska, B. (2023). Impaired Functional Status Increases Fracture Incidence in 10-year Follow-Up: The Results from RAC-OST-POL Study. Journal of Clinical Densitometry, 26, 104–108. 10.1016/J.JOCD.2022.12.009
- Sale, J. E.
M.,
Frankel,
L.,
Bogoch,
E.,
Carlin-Coleman,
G.,
Hui,
S.,
Saini,
J., et al.
(2024). The experience of feeling old after a
fragility fracture. BMC Geriatr,
24,
180 . https://doi.org/10.1186/S12877-024-04769-W/PEER-REVIEW - Schini, M., Johansson, H., Harvey, N. C., Lorentzon, M., Kanis, J. A., & McCloskey, E. V. (2024). An overview of the use of the fracture risk assessment tool (FRAX) in osteoporosis. J Endocrinol Invest, 47, 501–511. https://doi.org/10.1007/S40618-023-02219-9/TABLES/2
- Shetty, S., John, B., Mohan, S., & Paul, T. V. (2020). Vertebral fracture assessment by dual-energy X-ray absorptiometry along with bone mineral density in the evaluation of postmenopausal osteoporosis. Arch Osteoporos, 15. 10.1007/S11657-020-0688-9
- Shevroja, E, Cafarelli, F. P., Guglielmi, G., & Hans, D. (2021). DXA parameters, Trabecular Bone Score (TBS) and Bone Mineral Density (BMD), in fracture risk prediction in endocrine-mediated secondary osteoporosis. Endocrine, 74, 20–28. https://doi.org/10.1007/S12020-021-02806-X/FIGURES/2
- Söreskog, E., Ström, O., Spångéus, A., Åkesson, K. E., Borgström, F., Banefelt, J., et al. (2020). Risk of major osteoporotic fracture after first, second and third fracture in Swedish women aged 50 years and older. Bone, 134. 10.1016/J.BONE.2020.115286
- Sund, R., Rikkonen, T., Kröger, H., & Sirola, J. (2026). Burden of accumulating fragility fractures on health service usage and costs among post-menopausal women. Osteoporos Int, 37. 10.1007/S00198-025-07821-6
- Touloumis, A. (2015). R Package multgee: A Generalized Estimating Equations Solver for Multinomial Responses. J Stat Softw, 64, 1–14. 10.18637/JSS.V064.I08
- Wu, A. M., Bisignano, C., James, S. L., Abady, G. G., Abedi, A., Abu-Gharbieh, E., et al. (2021). Global, regional, and national burden of bone fractures in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet Healthy Longev, 2, e580–e592. 10.1016/S2666-7568(21)00172-0
- Yeh, E. J., Rajkovic-Hooley, O., Silvey, M., Ambler, W. S., Milligan, G., Pinedo-Villanueva, R., et al. (2023). Impact of fragility fractures on activities of daily living and productivity in community-dwelling women: a multi-national study. Osteoporosis International, 34, 1751–1762. https://doi.org/10.1007/S00198-023-06822-7/TABLES/3
DOI: https://doi.org/10.5334/paah.547 | Journal eISSN: 2515-2270
Language: English
Page range: 31 - 42
Submitted on: Jan 31, 2026
Accepted on: May 2, 2026
Published on: May 11, 2026
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year
Keywords:
© 2026 Samuli Juopperi, Joonas Sirola, Reijo Sund, Toni Rikkonen, Heikki Kröger, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.