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Submitted on August 5, 2004
Accepted on February 15, 2005
Oregon Health & Science University, Portland, Oregon; University of Minnesota and the Veterans Affairs Medical Center, Minneapolis, Minnesota; University of Pittsburgh, Pittsburgh, Pennsylvania; University of California at San Francisco, San Francisco, California; Kaiser Permanente Center for Health Research Northwest/ Hawaii Division, Portland, Oregon; University of Maryland, Baltimore, Maryland
* To whom correspondence should be addressed. E-mail: s wainwright{at}comcast.net.
The proportion of fractures that occur in women without osteoporosis has not been fully described and the characteristics of non-osteoporotic women who fracture are not well understood. We measured total hip bone mineral density (BMD) and baseline characteristics including physical activity, falls, and strength for 8065 women aged 65 or older participating in the Study of Osteoporotic Fractures (SOF), then followed these women for hip fracture for up to 5 yr after BMD measurement.
Among all participants, 17% had osteoporosis (total hip BMD T-score 
-2.5). Of the 243 women with incident hip fracture, 54% were not osteoporotic at start of follow-up. Non-osteoporotic women who fractured were less likely than osteoporotic women with fracture to have baseline characteristics associated with frailty. Nevertheless, among non-osteoporotic participants several characteristics increased fracture risk, including advancing age, lack of exercise in last year, reduced visual contrast sensitivity, falls in the last year, prevalent vertebral fracture, and lower total hip BMD.
These findings call attention to the many older women who suffer hip fracture but do not have particularly low antecedent BMD measures, and help begin to identify risk factors associated with higher bone density levels.
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