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Fracture Risk Prediction After Age 80 Years

Award Number: R21AG067094
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/30/2020
PERIOD OF PERFORMANCE END DATE: 05/31/2024

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Fracture Risk Prediction After Age 80 Years - The majority of clinical fractures including hip fractures occur among adults aged 80 years and older, but there is a paucity of evidence to guide assessment of fracture risk versus competing mortality risk in this expanding patient population. Clinicians have difficulty identifying late life patients who are at highest risk of fracture since expected survival strongly impacts this risk. No currently available fracture risk assessment tool adequately addresses important issues relevant to fracture prediction in the oldest old, including selection of appropriate timeframes for fracture prediction, inclusion of key risk factors for late life fractures and mortality, and consideration of a patient's competing mortality risk given his/her set of risk factors. Our preliminary data suggests that addition of non-skeletal risk factors such as the frailty phenotype to a fracture prediction model will improve its performance in late life adults. Thus, there is a critical need for pragmatic fracture risk assessment models that better identify women and men in the 9th and 10th decades of life at high risk of fracture. Our study will combine comprehensive data collected in three large epidemiologic cohorts (Study of Osteoporotic Fractures [SOF]; Osteoporotic Fractures in Men Study [MrOS]; Health Aging and Body Composition Study [Health ABC]) to yield fracture prediction models in community-dwelling women and in men aged 80 years and older that clearly define relationships between individual and combined risk factors for fracture accounting for the competing risk of mortality and demonstrate superior performance to that of existing tools. We will generate estimates of 5-year and lifetime risks considering relevant late life non-skeletal predictors of both fracture and mortality including multimorbidity, functional limitations, polypharmacy, the frailty phenotype and its components such as shrinking, weakness and slowness. In addition, we will evaluate the role of BMD in fracture prediction including its interaction with late life non-skeletal risk factors. Valid lifetime risk assessment with adequate consideration of a patient's competing mortality risk is warranted to identify those at highest risk of fracture prior to death. In addition, a 5-year prediction time frame among these high risk patients accounting for competing mortality risk is needed for clinical decision making given the anticipated time horizon of benefit of interventions to lower fracture risk and reduced life expectancy. Successful achievement of our aims will improve clinical decision making by clearly identifying higher risk patient subgroups who should be targeted for fracture screening and prevention approaches as fracture risk is high despite consideration of competing mortality risk and lower risk subgroups where these strategies may have minimal benefit as competing risk of death far outweighs fracture risk. These results are essential to guide fracture risk assessment and shared clinical decision making in this rapidly growing segment of the US population with its high burden of shared risk factors for both fracture events and competing non-fracture related mortality.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = -$891 )
2024	2021	REGENTS OF THE UNIVERSITY OF MINNESOTA	200 OAK ST SE	MINNEAPOLIS	MN	55455	HENNEPIN	USA	Aging Research	000	2	9/6/2024	NON-COMPETING CONTINUATION	-$891
														Subtotal = -$891

Issue Date FY: 2023 ( Subtotal = $0 )
2023	2021	REGENTS OF THE UNIVERSITY OF MINNESOTA	200 OAK ST SE # 224	MINNEAPOLIS	MN	55455	HENNEPIN	USA	Aging Research	000	2	5/10/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2021 ( Subtotal = $164,988 )
2021	2021	REGENTS OF THE UNIVERSITY OF MINNESOTA	200 OAK ST SE # 224	MINNEAPOLIS	MN	55455	HENNEPIN	USA	Aging Research	001	2	6/7/2021	NON-COMPETING CONTINUATION	$164,988
2021	2020	REGENTS OF THE UNIVERSITY OF MINNESOTA	200 OAK ST SE # 224	MINNEAPOLIS	MN	55455	HENNEPIN	USA	Aging Research	000	1	10/30/2020	NEW	$0
														Subtotal = $164,988

Issue Date FY: 2020 ( Subtotal = $171,488 )
2020	2020	REGENTS OF THE UNIVERSITY OF MINNESOTA	200 OAK ST SE # 224	MINNEAPOLIS	MN	55455	HENNEPIN	USA	Aging Research	000	1	9/18/2020	NEW	$171,488
														Subtotal = $171,488

Grand Total All Awards = $335,585

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Fracture Risk Prediction After Age 80 Years

Award Number: R21AG067094

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/30/2020

PERIOD OF PERFORMANCE END DATE: 05/31/2024

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