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A comprehensive fracture prevention strategy in older adults: The European Union Geriatric Medicine Society (EUGMS) statement

  • Published:
The journal of nutrition, health & aging

Abstract

Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest Group on Falls and Fracture Prevention of the European Union Geriatric Medicine Society (EUGMS), in collaboration with the International Association of Gerontology and Geriatrics for the European Region (IAGG-ER), the European Union of Medical Specialists (EUMS), the International Osteoporosis Foundation - European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people.

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References

  1. Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 2006;17:1726–33.

    Article  CAS  PubMed  Google Scholar 

  2. Fife D, Barancik JI. Northeastern Ohio Trauma Study III: incidence of fractures. Ann Emerg Med 1985;14:244–8.

    Article  CAS  PubMed  Google Scholar 

  3. Cummings SR, Nevitt MC. Non-skeletal determinants of fractures: the potential importance of the mechanics of falls. Study of Osteoporotic Fractures Research Group. Osteoporos Int 1994;4 Suppl 1:67–70

    Article  PubMed  Google Scholar 

  4. Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res 2007;22:465–75.

    Article  PubMed  Google Scholar 

  5. Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA 2009;301:513–21.

    Article  CAS  PubMed  Google Scholar 

  6. Cooper C, Cole ZA, Holroyd CR, Earl SC, Harvey NC, Dennison EM, et al. Secular trends in the incidence of hip and other osteoporotic fractures. IOF CSA Working Group on Fracture Epidemiology. Osteoporos Int 2011;22:1277–88.

    CAS  Google Scholar 

  7. Roux C, Wyman A, Hooven FH, Gehlbach SH, Adachi JD, Chapurlat RD, GLOW investigators et al. Burden of nonhip, non-vertebral fractures on quality of life in postmenopausal women: the Global Longitudinal study of Osteoporosis in Women (GLOW). Osteoporos Int 2012;23:2863–71.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Bischoff-Ferrari H. Fragility fractures: the future epidemic and its challenges. Skeletal Radiol. 2013;42:161–3.

    Article  PubMed  Google Scholar 

  9. Blain H, Abecassis F, Adnet PA, Alomène B, Amoyal M, Bardy B, et al. Living Lab Falls-MACVIA-LR: The falls prevention initiative of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) in Languedoc-Roussillon. Eur Geriatr Med 2014;5:416–25.

    Article  Google Scholar 

  10. European Innovation Partnership on Active and Healthy Ageing. ACTION PLAN A2 on Specific Action on innovation in support of ‘Personalized health management, starting with a Falls Prevention Initiative’ Update January 2013 https://ec.europa.eu/research/innovation-union/pdf/active-healthy-ageing/a2_action_plan.pdf

  11. Hung WW, Egol KA, Zuckerman JD, Siu AL. Hip fracture management: tailoring care for the older patient. JAMA 2012;307:2185–94.

    Article  CAS  PubMed  Google Scholar 

  12. Bischoff-Ferrari HA, Meyer O. Comparative effectiveness of pharmacologic treatments to prevent fractures: is this all we need to know? Ann Intern Med 2014;161:755–6.

    Article  PubMed  Google Scholar 

  13. Järvinen TL, Michaëlsson K, Jokihaara J, Collins GS, Perry TL, Mintzes B, et al. Overdiagnosis of bone fragility in the quest to prevent hip fracture. BMJ 2015;350:h2088.

    Article  PubMed  Google Scholar 

  14. Compston J. Overdiagnosis of osteoporosis: fact or fallacy? Osteoporos Int 2015;26:2051–4.

    Article  CAS  PubMed  Google Scholar 

  15. O’Loughlin JL, Robitaille Y, Boivin JF, Suissa S. Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly. Am J Epidemiol 1993;137:342–54.

    PubMed  Google Scholar 

  16. Tinetti ME. Clinical practice. Preventing falls in elderly persons. N Engl J Med 2003;348:42–9.

    Article  PubMed  Google Scholar 

  17. Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. New England Journal of Medicine 1988;319:1701–7.

    Article  CAS  PubMed  Google Scholar 

  18. Campbell AJ, Borrie MJ, Spears GF, Jackson SL, Brown JS, Fitzgerald JL. Circumstances and consequences of falls experienced by a community population 70 years and over during a prospective study. Age and Ageing 1990;19:136–41.

    Article  CAS  PubMed  Google Scholar 

  19. Milat AJ, Watson WL, Monger C, Barr M, Giffin M, Reid M. Prevalence, circumstances and consequences of falls among community-dwelling older people: results of the 2009 NSW Falls Prevention Baseline Survey. N S W Public Health Bull 2011;22:43–8.

    Article  PubMed  Google Scholar 

  20. Cameron ID, Gillespie LD, Robertson MC, Murray GR, Hill KD, Cumming RG, Kerse N. Interventions for preventing falls in older people in care facilities and hospitals. Cochrane Database Syst Rev 2012;12:CD005465.

    PubMed  Google Scholar 

  21. Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, Lamb SE. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 2012;9:CD007146.

    PubMed  Google Scholar 

  22. STEADI algorithm CDC’s Stopping Elderly Accidents, Deaths & Injuries (STEADI) Algorithm providing tools and educational material for health care providers. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention. Available from:stevens http://www.cdc.gov/homeandrecreationalsafety/Falls/steadi/index.html.7

  23. Stevens JA, Phelan EA. Development of STEADI: a fall prevention resource for health care providers. Health Promot Pract 2013;14:706–14.

    Article  PubMed  Google Scholar 

  24. El-Khoury F, Cassou B, Latouche A, Aegerter P, Charles MA, Dargent-Molina P. Effectiveness of two year balance training programme on prevention of fall induced injuries in at risk women aged 75-85 living in community: Ossébo randomised controlled trial. BMJ 2015;351:h3830.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Wagner H, Melhus H, Gedeborg R, Pedersen NL, Michaëlsson K. Simply ask them about their balance—future fracture risk in a nationwide cohort study of twins. Am J Epidemiol 2009;169:143–9.

    Article  PubMed  Google Scholar 

  26. Caillet P, Klemm S, Ducher M, Aussem A, Schott AM. Hip fracture in the elderly: a re-analysis of the EPIDOS study with causal Bayesian networks. PLoS One 2015;10:e0120125.

    Google Scholar 

  27. Furrer R, van Schoor NM, de Haan A, Lips P, de Jongh RT. Gender-specific associations between physical functioning, bone quality, and fracture risk in older people. Calcif Tissue Int 2014;94:522–30.

    Article  CAS  PubMed  Google Scholar 

  28. Lundin H, Sääf M, Strender LE, Nyren S, Johansson SE, Salminen H. One-leg standing time and hip-fracture prediction. Osteoporos Int 2014;25:1305–11.

    Article  CAS  PubMed  Google Scholar 

  29. Lord SR, March LM, Cameron ID, Cumming RG, Schwarz J, Zochling J, Chen JS, Makaroff J, Sitoh YY, Lau TC, Brnabic A, Sambrook PN. Differing risk factors for falls in nursing home and intermediate-care residents who can and cannot stand unaided. J Am Geriatr Soc. 2003;51:1645–50.

    Article  PubMed  Google Scholar 

  30. El-Khoury F, Cassou B, Charles MA, Dargent-Molina P. The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults: systematic review and meta-analysis of randomised controlled trials. BMJ 2013;347:f6234.

    PubMed  PubMed Central  Google Scholar 

  31. Stubbs B, Brefka S, Denkinger MD. What Works to Prevent Falls in Community-Dwelling Older Adults? Umbrella Review of Meta-analyses of Randomized Controlled Trials. Phys Ther 2015;95:1095–110.

    Article  PubMed  Google Scholar 

  32. Keall MD, Pierse N, Howden-Chapman P, Cunningham C, Cunningham M, Guria J, Baker MG. Home modifications to reduce injuries from falls in the home injury prevention intervention (HIPI) study: a cluster-randomised controlled trial. Lancet 2015;385:231–8.

    Article  PubMed  Google Scholar 

  33. Li W, Procter-Gray E, Lipsitz LA, Leveille SG, Hackman H, Biondolillo M, Hannan MT. Utilitarian walking, neighborhood environment, and risk of outdoor falls among older adults. Am J Public Health. 2014;104:e30–7.

    Article  Google Scholar 

  34. Campbell AJ, Robertson MC. Fall prevention: single or multiple interventions? Single interventions for fall prevention. J Am Geriatr Soc 2013;61:281–4.

    Article  PubMed  Google Scholar 

  35. Vlaeyen E, Coussement J, Leysens G, Van der Elst E, Delbaere K, Cambier D, et al. Center of Expertise for Fall and Fracture Prevention Flanders. Characteristics and effectiveness of fall prevention programs in nursing homes: a systematic review and meta-analysis of randomized controlled trials. J Am Geriatr Soc 2015;63:211–21.

    Article  PubMed  Google Scholar 

  36. Day LM. Fall prevention programs for community-dwelling older people should primarily target a multifactorial intervention rather than exercise as a single intervention. J Am Geriatr Soc 2013;61:284–5.

    Article  PubMed  Google Scholar 

  37. Ambrose AF, Cruz L, Paul G. Falls and Fractures: A systematic approach to screening and prevention. Maturitas 2015;82:85–93.

    Article  PubMed  Google Scholar 

  38. Zhang W, Zhu C, Sun M, Ge Y, Yan G. Efficacy of bisphosphonates against hip fracture in elderly patients with stroke and Parkinson diseases: meta-analysis of randomized controlled trials. J Stroke Cerebrovasc Dis 2014;23:2714–24.

    Article  PubMed  Google Scholar 

  39. Taylor BC, Schreiner PJ, Stone KL, Fink HA, Cummings SR, Nevitt MC, et al. Long-term prediction of incident hip fracture risk in elderly white women: study of osteoporotic fractures. J Am Geriatr Soc 2004;52:1479–86.

    Article  PubMed  Google Scholar 

  40. Kojima G. Frailty as a Predictor of Future Falls Among Community-Dwelling Older People: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2015;S1525–8610:00439–9.

    Google Scholar 

  41. Beswick AD, Rees K, Dieppe P, Ayis S, Gooberman-Hill R, Horwood J, Ebrahim S. Complex interventions to improve physical function and maintain independent living in elderly people: a systematic review and meta-analysis. Lancet 2008;371:725–35.

    Article  PubMed  PubMed Central  Google Scholar 

  42. American Geriatrics Society/British geriatrics Society clinical practice guideline:prevention of falls in older persons (2010). New York, NY: American Geriatrics Society, 2011. Available from http://www.americangeriatrics.org/health care professionals/clinical practice/clinical guidelines recommendations/2010.

  43. Rizzoli R, Bianchi ML, Garabédian M, McKay HA, Moreno LA. Maximizing bone mineral mass gain during growth for the prevention of fractures in the adolescents and the elderly. Bone 2010;46:294–305.

    Article  PubMed  Google Scholar 

  44. Specker B, Minett M. Can physical activity improve peak bone mass? Curr Osteoporos Rep 2013;11:229–36.

    Article  PubMed  Google Scholar 

  45. Golden NH, Abrams SA; Committee on Nutrition. Optimizing bone health in children and adolescents. Pediatrics 2014;134:e1229–43.

    Article  Google Scholar 

  46. Harvey N, Dennison E, Cooper C. Osteoporosis: a lifecourse approach. J Bone Miner Res 2014;29:1917–25.

    Article  PubMed  Google Scholar 

  47. Milte R, Crotty M. Musculoskeletal health, frailty and functional decline. Best Pract Res Clin Rheumatol 2014;28:395–410.

    Article  CAS  PubMed  Google Scholar 

  48. Kanis JA, McCloskey EV, Johansson H, Cooper C, Rizzoli R, Reginster JY; Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and the Committee of Scientific Advisors of the International Osteoporosis Foundation (IOF). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 2013;24:23–57.

    Article  CAS  PubMed  Google Scholar 

  49. Kanis JA, Rizzoli R, Cooper C, Reginster JY. Challenges for the development of bone-forming agents in Europe. Calcif Tissue Int 2014;94:469–73.

    Article  CAS  PubMed  Google Scholar 

  50. Kanis JA, McCloskey E, Branco J, Brandi ML, Dennison E, Devogelaer JP, Ferrari S, Kaufman JM, Papapoulos S, Reginster JY, Rizzoli R. Goal-directed treatment of osteoporosis in Europe. Osteoporos Int 2014;25:2533–43.

    Article  CAS  PubMed  Google Scholar 

  51. Rizzoli R, Branco J, Brandi ML, Boonen S, Bruyère O, Cacoub P, Cooper C, Diez-Perez A, Duder J, Fielding RA, Harvey NC, Hiligsmann M, Kanis JA, Petermans J, Ringe JD, Tsouderos Y, Weinman J, Reginster JY. Management of osteoporosis of the oldest old. Osteoporos Int 2014;25:2507–29.

    Article  CAS  PubMed  Google Scholar 

  52. Kanis JA, Melton LJ 3rd, Christiansen C, Johnston CC, Khaltaev N. The diagnosis of osteoporosis. J Bone Miner Res 1994;9:1137–41.

    Article  CAS  PubMed  Google Scholar 

  53. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. Geneva, World Health Organization, 1994 (WHO Technical Report Series, No. 843)

    Google Scholar 

  54. International Society for Clinical Densitometry. 2013 Official Positions- Adult. http://www.iscd.org/official-positions/2013-iscd-official-positions-adult/.

  55. Masud T, Langley S, Wiltshire P, Doyle DV, Spector TD. Effect of spinal osteophytosis on bone mineral density measurements in vertebral osteoporosis. BMJ 1993;307:172–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Kanis JA, McCloskey EV, Johansson H, Oden A, Melton LJ 3rd, Khaltaev N. A reference standard for the description of osteoporosis. Bone. 2008;42:467–75.

    Article  CAS  PubMed  Google Scholar 

  57. Kanis JA, Hans D, Cooper C, Baim S, Bilezikian JP, Binkley N, et al, and the Task Force of the FRAX Initiative. Interpretation and use of FRAX in clinical practice. Osteoporos Int 2011; 22: 395–411.

    Google Scholar 

  58. Blain H, Rolland Y, Beauchet O, Annweiler C, Benhamou CL, Benetos A, et al; Groupe de recherche et d’information sur les ostéoporoses et la Société française de gérontologie et gériatrie. Usefulness of bone density measurement in fallers. Joint Bone Spine 2014;81:403–8.

    Article  PubMed  Google Scholar 

  59. Nevitt MC, Cummings SR. Type of fall and risk of hip and wrist fractures: The study of osteoporotic fractures. J Am Geriatr Soc 1993;41:1226–34.

    Article  CAS  PubMed  Google Scholar 

  60. Schuit SC, van der Klift M, Weel AE, de Laet CE, Burger H, Seeman E, Hofman A, et al. Fracture incidence and association with bone mineral density in elderly men and women: the Rotterdam Study. Bone 2004;34:195–202

    Article  CAS  PubMed  Google Scholar 

  61. Crandall CJ, Newberry SJ, Diamant A, Lim YW, Gellad WF, Booth MJ, et al. Comparative effectiveness of pharmacologic treatments to prevent fractures: an updated systematic review. Ann Intern Med 2014;161:711–23.

    Article  PubMed  Google Scholar 

  62. Lyles KW, Colón-Emeric CS, Magaziner JS, Adachi JD, Pieper CF, Mautalen C, for the HORIZON Recurrent Fracture Trial et al. Zoledronic acid in reducing clinical fracture and mortality after hip fracture. N Engl J Med 2007;357:nihpa40967

    Google Scholar 

  63. Eriksen EF, Díez-Pérez A, Boonen S. Update on long-term treatment with bisphosphonates for postmenopausal osteoporosis: a systematic review. Bone 2014;58:126–35.

    Article  CAS  PubMed  Google Scholar 

  64. Hiligsmann M, Evers SM, Ben Sedrine W, Kanis JA, Ramaekers B, Reginster JY, Silverman S, Wyers CE, Boonen A. A systematic review of cost effectiveness analyses of drugs for postmenopausal osteoporosis. Pharmacoeconomics 2015;33:205–24.

    Article  PubMed  Google Scholar 

  65. Boonen S, Black DM, Colón-Emeric CS, Eastell R, Magaziner JS, Eriksen EF et al. Efficacy and safety of a once-yearly intravenous zoledronic acid 5 mg for fracture prevention in elderly postmenopausal women with osteoporosis aged 75 and older. J Am Geriatr Soc 2010;58:292–9.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Boonen S, McClung MR, Eastell R, El-Hajj Fuleihan G, Barton IP, Delmas P. Safety and efficacy of risedronate in reducing fracture risk in osteoporotic women aged 80 and older: implications for the use of antiresorptive agents in the old and oldest old. J Am Geriatr Soc 2004;52:1832–9.

    Article  PubMed  Google Scholar 

  67. Boonen S, Marin F, Mellstrom D, Xie L, Desaiah D, Krege JH, Rosen CJ. Safety and efficacy of teriparatide in elderly women with established osteoporosis: bone anabolic therapy from a geriatric perspective. J Am Geriatr Soc 2006;54:782–9.

    Article  PubMed  Google Scholar 

  68. Hochberg MC, Thompson DE, Black DM, Quandt SA, Cauley J, Geusens P, FIT Research Group et al. Effect of alendronate on the age-specific incidence of symptomatic osteoporotic fractures. J Bone Miner Res 2005;20:971–6.

    Article  CAS  PubMed  Google Scholar 

  69. Eastell R, Black DM, Boonen S, Adami S, Felsenberg D, Lippuner K, HORIZON Pivotal Fracture Trial et al. Effect of once yearly zoledronic acid five milligrams on fracture risk and change in femoral neck bone mineral density. J Clin Endocrinol Metab 2009;94:3215–25.

    Article  CAS  PubMed  Google Scholar 

  70. Reginster JY, Seeman E, De Vernejoul MC, Adami S, Compston J, Phenekos C, et al. Strontium ranelate reduces the risk of nonvertebral fractures in postmenopausal women with osteoporosis: Treatment of Peripheral Osteoporosis (TROPOS) study. J Clin Endocrinol Metab 2005;90:2816–22.

    Article  CAS  PubMed  Google Scholar 

  71. Boonen S, Adachi JD, Man Z, Cummings SR, Lippuner K, Törring O, et al. Treatment with denosumab reduces the incidence of new vertebral and hip fractures in postmenopausal women at high risk. J Clin Endocrinol Metab 2011;96:1727–36

    Article  CAS  PubMed  Google Scholar 

  72. Rolland Y, Abellan Van Kan G, Gillette-Guyonnet S, Roux C, Boonen S, Vellas B. Strontium ranelate and risk of vertebral fractures in frail osteoporotic women. Bone 2011;48:332–8.

    Article  CAS  PubMed  Google Scholar 

  73. Greenspan SL, Perera S, Ferchak MA, Nace DA, Resnick NM. Efficacy and safety of single-dose zoledronic acid for osteoporosis in frail elderly women: a randomized clinical trial. JAMA Intern Med 2015;175:913–21.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Clinician’s guide to prevention and treatment of osteoporosis; National Osteoporosis Foundation 2014.http://nof.org/files/nof/public/content/file/2791/upload/919.pdf

  75. Javaid MK, Kyer C, Mitchell PJ, Chana J, Moss C, Edwards MH et al; IOF Fracture Working Group; EXCO. Effective secondary fracture prevention: implementation of a global benchmarking of clinical quality using the IOF Capture the Fracture® Best Practice Framework tool. Osteoporos Int 2015;26:2573–8.

    Article  CAS  PubMed  Google Scholar 

  76. Solomon DH, Patrick AR, Schousboe J, Losina E. The potential economic benefits of improved post-fracture care: a costeffectiveness analysis of a fracture liaison service in the US health-care system. J Bone Miner Res 2014;29:1667–747.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Yong JH, Masucci L, Hoch JS, Sujic R, Beaton D. Cost-effectiveness of a fracture liaison service-a real-world evaluation after 6 years of service provision. Osteoporos Int 2016;27:231–40.

    Article  CAS  PubMed  Google Scholar 

  78. Majumdar SR, Kim N, Colman I, Chahal AM, Raymond G, Jen H, et al. Incidental vertebral fractures discovered with chest radiography in the emergency department: prevalence, recognition, and osteoporosis management in a cohort of elderly patients. Arch Intern Med 2005;165:905–9.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Internal Medicine and Geriatrics, Montpellier University hospital, Montpellier, France

    H. Blain

  2. EA 2991 Movement To Health, Euromov, Montpellier University, Montpellier, France

    H. Blain

  3. MacVia-LR, EIP-AHA reference Site, Montpellier, France

    H. Blain

  4. Pôle de Gériatrie, Centre Antonin-Balmes, CHU de Montpellier, 39, avenue Charles-Flahault, 34395, Montpellier Cedex 5, France

    H. Blain

  5. Department of Geriatric Medicine, Nottingham University Hospitals NHS Trust Nottingham, Nottingham, UK

    T. Masud

  6. INSERM, U1153, ORCHARD Team, Centre of Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris Descartes University, Paris, France

    P. Dargent-Molina

  7. EUGMS, Paris, France

    P. Dargent-Molina

  8. Department of Ageing and Health, Guy’s and St Thomas’ NHS Trust, London, UK

    F. C. Martin

  9. Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden

    E. Rosendahl

  10. Geriatrics Department Academisch Medisch Centrum Geriatrie, Amsterdam, The Netherlands

    N. van der Velde

  11. Respiratory Diseases Department, Montpellier University hospital, Montpellier, France

    J. Bousquet

  12. Inserm U1018, Villejuif, France

    J. Bousquet

  13. MacVia-LR, EIP-AHA reference Site, Paris, France

    J. Bousquet

  14. Department of Geriatrics, University Hospital of Nancy, Nancy, France

    A. Benetos

  15. Inserm, U1116, CIC-P 1433, Université de Lorraine, Lorraine, France

    A. Benetos

  16. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK

    C. Cooper

  17. NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK

    C. Cooper

  18. ESCEO/IOF, Southampton, UK

    C. Cooper

  19. WHO Collaborative Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK

    J. A. Kanis

  20. Department of Public Health, Epidemiology and Health Economics, University of Liege, CHU Sart Tilman B23, 4000, Liège, Belgium

    J. Y. Reginster

  21. Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland

    R. Rizzoli

  22. Hôpital Roger Salengro, Lille, France

    B. Cortet

  23. Geriatric Unit, University of Palermo, Palermo, Italy

    M. Barbagallo

  24. Gérontopôle, Institute of Ageing, University Hospital Toulouse, Toulouse, France

    B. Vellas

  25. National Research Council, Aging Branch, Institute of Neuroscience, Padova, Italy

    S. Maggi

  26. University of Helsinki, and Helsinki University Central Hospital, Helsinki, Finland

    T. Strandberg

  27. Center for Life Course Health Research, University of Oulu, Oulu, Finland

    T. Strandberg

  28. Dept. for muskuloskeletal Rehabilitation, Prevention and Health Service Research Center for Sport Science and Sport Medicine (CSSB) Center for Musculoskeletal Sugery (CMSC) Charité, Universitätsmedizin Berlin, Berlin, Germany

    K. E. Dreinhöfer

  29. Dept. of Orthopedics and Traumatology Medical Park Berlin, Berlin, Germany

    K. E. Dreinhöfer

  30. Fragility Fracture Network, Berlin, Germany

    K. E. Dreinhöfer

Authors
  1. H. Blain
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  2. T. Masud
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  3. P. Dargent-Molina
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  4. F. C. Martin
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  5. E. Rosendahl
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  6. N. van der Velde
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  7. J. Bousquet
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  8. A. Benetos
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  9. C. Cooper
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  10. J. A. Kanis
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  11. J. Y. Reginster
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  12. R. Rizzoli
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  13. B. Cortet
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  14. M. Barbagallo
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  15. K. E. Dreinhöfer
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  16. B. Vellas
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  17. S. Maggi
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  18. T. Strandberg
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Consortia

the EUGMS Falls and Fracture Interest Group, the International Association of Gerontology and Geriatrics for the European Region (IAGG-ER), the European Union of Medical Specialists (EUMS)

the Fragility Fracture Network (FFN), the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO), and the International Osteoporosis Foundation (IOF)

Corresponding author

Correspondence to H. Blain.

Additional information

For the EUGMS Falls and Fracture Interest Group: Marta Neira Alvarez, Department of Geriatric Medicine of Infanta, Sofia University Hospital. S S Reyes. Madrid, Spain. (marta.neira@yahoo.es); Cedric Annweiler, Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital; University Memory Clinic; UPRES EA 4638, University of Angers, UNAM, Angers, France; Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, the University of Western Ontario, London, Ontario, Canada. (CeAnnweiler@chu-angers.fr); Pierre Louis Bernard, UFR-STAPS, Université Montpellier, EA 2991 EuroMov, Montpellier, France. (pbernard@univ-montp1.fr); Natalie Beswetherick, OBE MBA FCSP, Chartered Society of Physiotherapy, London, UK. (beswetherickn@csp.org. uk); Heike A. Bischoff-Ferrari, Department. of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, Switzerland; ESCEO/IOF. (Heike.Bischoff@usz.ch); Frédéric Bloch, Department of Gerontology, Hopital Broca (AP-HP), and University Paris-Descartes, EA 4468, Paris, France. (frederic.bloch@brc.aphp.fr); Jacques Boddæert, Unit of Peri-Operative Geriatric care, Geriatric Department Pitié-Salpêtrière Hospital, CNRS UMR8256 Pierre et Marie Curie University, UPMC Paris 6, France. (jacques.boddaert@psl.aphp.fr); Marc Bonnefoy, Department of Geriatrics, Groupement Hospitalier Sud–HCL Université Claude Bernard, Unité INSERM 1060 69495, Pierre-Bénite Cedex, France. (marc.bonnefoy@chu-lyon.fr); Isabelle Bourdel-Marchasson, Clinical Gerontology Department, CHU Bordeaux, RMSB, UMR 5536, CNRS, Bordeaux University, France. (isabelle.bourdel-marchasson@chu-bordeaux.fr); Ana Capisizu, University of Medicine and Pharmacy «Carol Davila» Geriatric Department - «St Luke» Hospital, Bucharest, Romania. (anacapisizu@yahoo.com); Hélène Che, Département de rhumatologie, Pole Os et articulations, Hopital Lapeyronie Université de Montpellier, Montpellier, France. (h-che@chu-montpellier.fr); João Gorjão Clara, Geriatric University Unit, Instituto de Medicina Preventiva, Faculdade de Medicina da Universidade de Lisboa, Portugal. (gorjaoclara@gmail.com); Bernard Combe, Département de rhumatologie, Pole Os et articulations, Hopital Lapeyronie Université Montpellier I, Montpellier, France; Société Française de Rhumatologie. (b-combe@chu-montpellier.fr); Didier Delignieres, UFR-STAPS, Université Montpellier, EA 2991 EuroMov, Montpellier, France. (didier.delignieres@univ-montp1.fr); Patrik Eklund, Department of Computing Science, Umeå University, SE-90187 Umeå, Sweden. (pe@fourcomp.com); Marielle Emmelot-Vonk, Department of Geriatrics, University Medical Centre Utrecht, The Netherlands. (M.H.EmmelotVonk@umcutrecht.nl); Ellen Freiberger, Institute for Biomedicine of Aging, Nürnberg, Germany. (ellen.freiberger@fau.de); Jean-Bernard Gauvain, Court Séjour Gériatrique, CHR Orléans, France; GRIO. (jean-bernard.gauvain@chr-orleans.fr); Nandu Goswami, Institute of Physiology, Medical University of Graz, Austria. (nandu. goswami@medunigraz.at); Nick Guldemond, University Medical Centre Utrecht, The Netherlands, (N.A.Guldemond@umcutrecht.nl); Álvaro Casas Herrero, F.E.A Geriatría Complejo Hospitalario Navarra, Pamplona, Spain. (alvaro.casas.herrero@navarra.es); Marie-Eve Joël, Université Paris-Dauphine, Paris, France. (Marie-Eve.Joel@dauphine. fr); Anna Björg Jónsdóttir, Department of Geriatric Medicine The National.University Hospital of Iceland, Reykjavík–Iceland. (annabjon@landspitali.is); Gilles Kemoun, Laboratoire EA 6314, Université de Poitiers, Institut de Recherche sur le Handicap et le Vieillissement, Paris, France. (gilles.kemoun@wanadoo.fr); Istvan Kiss, Division Section of Geriatrics, 2nd Department of Internal Medicine, Semmelweis University, Budapest, Hungary (ikiss@enternet.hu); Helgi Kolk, Department of Traumatology and Orthopaedics, Tartu University Hospital, Estonia. (Helgi.Kolk@kliinikum.ee); Marek L Kowalski, Department of Immunology, Rheumatology and Allergy, Medical University of Lodz, Poland. (Marek.Kowalski@csk.am.lodz.pl); Štefan Krajcík, Geriatric department, Slovak Medical University, Bratislava, Slovakia. (skrajcik@szu.sk); Yesim Gökçe Kutsal, Director of Hacettepe University Research Center of Geriatric Sciences, Turkey. (ygkutsal@gmail.com); Fulvio Lauretani, University Hospital of Parma, Parma, Italy. (flauretani@ao.pr.it); Jūratė Macijauskienė, Department of Geriatrics, Medical Academy, Lithuanian University of Health Sciences; Kaunas, Lithuania. (jurate.macijauskiene@lsmuni.lt); Marte Mellingsæter, Akershus University hospital, Norway. (cmelling@online.no); France Mourey, Inserm 1093 UFR santé université Bourgogne Franche-Comté, France. (france.mourey@u-bourgogne.fr); Fati Nourashemi, Gérontopôle de Toulouse, France. (nourhashemi.f@chu-toulouse.fr); Csaba Nyakas, Semmelweis University, Faculty of Health Sciences, Research Unite for Behavioral Physiology, Budapest, Hungary. (nyakas@tf.hu); François Puisieux, Département de Gériatrie, CHU de Lille, France. (Francois. puisieux@chru-lille.fr); Patrick Rambourg, Pôle de pharmacie, CHU Montpellier, France. (p-rambourg@chu-montpellier.fr); Alfonso González Ramírez, Working Group of Osteoporosis, Falls and Fractures of the Spanish Geriatrics Society; Unit of Geriatrics - Universitary Hospital of Salamanca, Spain. (alfonsogr@segg.es); Kilian Rapp, Department of Geriatrics and Geriatric Rehabilitation, Robert-Bosch-Hospital, Stuttgart, Germany (Kilian.Rapp@rbk.de); Yves Rolland, Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse; Unité Mixe de Recherche, Institut National de la Santé et de la Recherche Médicale 1027, University of Toulouse III, Toulouse, France. (rolland.y@chu-toulouse.fr); Jesper Ryg, Department of Geriatric Medicine, Odense University Hospital, Department of Clinical Research, University of Southern Denmark. (Jesper.Ryg@rsyd.dk); Opinder Sahota, Department of Orthogeriatric Medicine & Consultant Physician, QMC, Nottingham University Hospitals NHS Trust, UK. (opinder. sahota@nuh.nhs.uk); Sanne Snoeijs, Department of care demand of the chronically ill and disabled International Comparative Health Services Research, Utrecht, The Netherlands. (s.snoeijs@nivel.nl); Yannick Stephan, EA 4556 Dynamic of Human Abilities and Health Behaviors, University of Montpellier, France. (yannick.stephan@univmontp1. fr); Eric Thomas, Departement de rhumatologie, Pole Os et articulations, Hopital Lapeyronie, Université de Montpellier, Montpellier, France. (e-thomas@chu-montpellier. fr); Chris Todd, School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK. (Chris.Todd@manchester.ac.uk); Jonathan Treml, Co-Chair British Geriatrics Society Falls and Bone Health Section.Department of Geriatric Medicine, Queen Elizabeth Hospital, Birmingham UK. (Jonathan.Treml@uhb.nhs.uk).

For the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO), Osteoporosis Research and Information Group (GRIO), and International osteoporosis Foundation (IOF): Rick Adachi, St. Joseph’s Hospital, Western University, London, Ontario, Canada;IOF. (jd.adachi@sympatico.ca); Donato Agnusdei, Skeletal Diseases, Eli Lilly and Co., Italy; IOF. (donato@lilly.com); Jean-Jacques Body, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium; ESCEO/IOF. (jean-jacques.body@chu-brugmann.be); Olivier Bruyère, Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium; ESCEO/IOF. (olivier.bruyere@ulg.ac.be); Peter Burckardt, Hirslanden Bois Cerf, Lausanne, Switzerland; ESCEO/IOF. (pburckhardt@eva-basel.ch); Jorge B. Cannata-Andia, Bone and Mineral Research Unit, Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo, Spain; ESCEO/IOF. (cannata@hca.es); John Carey, Department of Rheumatology, Galway University Hospitals, Galway, Republic of Ireland National University of Ireland Galway, Galway, Republic of Ireland; ESCEO/IOF. (john.carey@hse.ie) Dinh-Chen Chan, Department of Gerontology and Geriatrics, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan; IOF. (dingchengchan@ntu. edu.tw); Thierry Chevalley, Division of Bone Diseases, University Hospitals and Faculty of Medicine, Geneva, Switzerland; ESCEO/IOF (thierry.chevalley@hcuge.ch) Martine Cohen-Solal, Inserm U1132 & USPC Paris-Diderot, Department of rheumatology, Hôpital Lariboisière, France; GRIO. (martine.cohen-solal@inserm.fr); Bess Dawson-Hughes, Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA; IOF. (bess.dawson-hughes@tufts. edu); Elaine M Dennison, NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton, Southampton, UK; ESCEO/IOF (emd@mrc.soton.ac.uk); Jean-Pierre Devogelaer, Department of Rheumatology, Saint-Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium; ESCEO/ IOF. (devogelaer@ruma.ucl.ac.be); Patrice Fardellone, Department of Rheumatology, Hôpital Nord,; INSERM U1088, Amiens, France; GRIO. (fardellone.patrice@chu-amiens. fr); Jean-Marc Féron (Department of Orthopaedic and Trauma Surgery. Saint Antoine Hospital. UPMC-Sorbonne Universités. Paris, France; GRIO. (jean-marc.feron@aphp.fr); Adolfo Diez Perez, Department of Internal Medicine, Hospital del Mar, Director of the Bone and Joint Research Unit at the Municipal Institute of Medical Research, Barcelona, Spain, ESCEO/IOF. (adiez@imas.imim.es); Dieter Felsenberg, Centre for Muscle and Bone Research, Charité Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Germany; ESCEO/IOF. (dieter.felsenberg@charite.de); Claus Glueer, Universitatsklinikum Schleswig-Holstein, Kiel, Germany; ESCEO/IOF (glueer@rad.uni-kiel.de); Nocholas Harvey, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, SO16 6YD, UK; ESCEO/IOF. (nch@mrc.soton.ac.uk); Mickael Hiligsman, Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht University,, The Netherlands; ESCEO/IOF. (m.hiligsmann@maastrichtuniversity.nl); Muhammad Kassim Javaid, NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, University of Oxford, Oxford, UK, ESCEO/IOF. (kassim.javaid@ndorms.ox.ac.uk); Niklas Rye Jörgensen, Research Center for Ageing and Osteoporosis, Department of Clinical Biochemistry, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark; Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Denmark, ESCEO/IOF (niklas@dadlnet.dk); David Kendler, University of British Columbia, Vancouver, Canada; IOF. (davidkendler@gmail.com); Marius Kraenzlin, University Hospital Basel, Petersgraben, Basel, Switzerland; ESCEO/IOF. (marius.kraenzlin@unibas.ch); William D Leslie, College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; IOF. (bleslie@sbgh. mb.ca); E. Michael Lewiecki, New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM, USA; IOF. (mlewiecki@gmail.com); Toshitaka Nakamura, National Center for Global Health and Medicine, Tokyo 162-8655, Japan; IOF (t-nak@utopia. ocn.ne.jp) Alexandra Papaioannou, Department of Medicine, McMaster University, Hamilton, ON, Canada; IOF. (papaioannou@hhsc.ca); Christian Roux, Department of Rheumatology, Cochin Hospital, and Epidemiology and Biostatistics Unit, Sorbonne Paris Cité Research Center, Paris Descartes University, INSERM U1153, Paris, France; ESCEO/ GRIO/IOF. (christian.roux@aphp.fr); Stuart Silverman, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 90048, USA, IOF. (stuarts@bhillsra.com); Manuel Sosa Henriquez Research Group into Osteoporosis and Mineral Metabolism, University of Las Palmas de Gran Canaria, Spain; Bone Metabolism Unit, Internal Medicine Service, University Insular Hospital, Las Palmas de Gran Canaria, Spain; ESCEO/IOF. (msosa@ono.com); Thierry Thomas hôpital de Bellevue, Saint-Etienne, France; Groupe de Recherche et d’Information sur les Osteoporoses, ESCEO/GRIO//IOF. (thierry.thomas@chu-st-etienne.fr); Samual Vasikaran School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, WA, 6009, Australia; IOF. (samuel.vasikaran@health.wa.gov.au); Nelson B. Watts, Mercy Health Osteoporosis and Bone Health Services Clinical Trial Center.), Cincinnati, Ohio, USA; IOF. (nelson.watts@uc.edu); Georges Weryha, CHU de Nancy, service d’endocrinologie, 54500 Vandoeuvre-lès-Nancy, France; GRIO. (g.weryha@chu-nancy.fr); Valérie Bousson, Service de Radiologie Ostéoarticulaire, Hôpital Lariboisière, Paris, France; GRIO. (valerie.bousson@aphp.fr); Véronique Breuil, Nice University Hospital, Pasteur 2 Hospital, Department of Rheumatology; UMR E-4320 TIRO-MATOs CEA/iBEB, Nice Sophia Antipolis University, France; GRIO (breuil.v@chu-nice.fr); Laure Chapuis, Service de rhumatologie, 35500 Vitré, France; GRIO. (laure.chapuis@wanadoo.fr); Michel Laroche, Centre de Rhumatologie, CHU Purpan, Toulouse; GRIO. (laroche.m@chu-toulouse.fr); Erick Legrand, Service de rhumatologie, CHU Angers, France; GRIO. (ErLegrand@chu-angers.fr); Eric Lespessailles, Service de Rhumatologie - CHR Orléans - La Source, France; GRIO. (eric.lespessailles@chr-orleans.fr); Jacques Morel, Département de rhumatologie, Pole Os et articulations, Hopital Lapeyronie Université Montpellier I, Montpellier, France; Société Française de Rhumatologie. (j-morel@chu-montpellier.fr)

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Blain, H., Masud, T., Dargent-Molina, P. et al. A comprehensive fracture prevention strategy in older adults: The European Union Geriatric Medicine Society (EUGMS) statement. J Nutr Health Aging 20, 647–652 (2016). https://doi.org/10.1007/s12603-016-0741-y

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