Comparison of the time-dependent discriminatory accuracy of femoral strength and bone mineral density for predicting future hip and major osteoporotic fractures: a 16-year follow-up of the AGES-Reykjavik cohort
Authors' conclusion
However, femoral strength demonstrates better discriminatory accuracy than aBMD.
Study context
- Population
- Older adults in the AGES-Reykjavik Study (mean age 76 ± 5 years) with CT scans at entry
- Participants
- 4,621 adults
- Exposure
- Finite element (FE)-derived femoral strength vs areal bone mineral density (aBMD) from CT scans for predicting hip and major osteoporotic fractures
- Outcome
- Time-dependent AUC for hip fractures (HFs) and major osteoporotic fractures (MOFs)
- Follow-up
- 16 years
Methodological detailstime-dependent ROC analysis, accounting for mortality risk, 16-year follow-up
- Time-dependent ROC analysis
- Accounting for mortality risk
- 16-year follow-up
Main finding
As reported in the abstract
- AUCs in predicting major osteoporotic fractures (MOFs) were similar
- Femoral strength vs aBMD: P < 0.05
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value |
|---|---|---|
| Sensitivity at comparable specificity, optimal (Youden) femoral strength cutoff vs aBMD | sensitivity difference, HFs 5-19% | P < 0.05 |
| Sensitivity at comparable specificity, optimal (Youden) femoral strength cutoff vs aBMD | sensitivity difference, MOFs 2-10% | P < 0.05 |
- Sensitivity and specificity of World Health Organization (WHO)-defined aBMD cutoffs for HFs and MOFs
- 17-52% · sensitivity · specificity 78-94%
Original publication
Comparison of the time-dependent discriminatory accuracy of femoral strength and bone mineral density for predicting future hip and major osteoporotic fractures: a 16-year follow-up of the AGES-Reykjavik cohort. Osteoporos Int. Published 12 May 2025. doi:10.
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