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To the Editor: Dr Cauley and colleagues¹ reported that women aged 65 years and older in the Study of Osteoporotic Fractures who had prevalent vertebral fracture had more than a 4-fold increased odds of subsequent incident vertebral fracture in the next 10 years. This finding is consistent with the Framingham Study² for which we were coauthors, demonstrating the importance of prevalent vertebral fracture as a risk factor for subsequent vertebral fracture.

However, the authors stated that "[i]n the Framingham Study, neither bone mass as measured by metacarpal area or prevalent vertebral fractures were significantly associated with incident vertebral fractures over 25 years."¹ We reported that in a subgroup of participants with moderate to severe incident fracture, prevalent fracture was associated with a 5-fold increased odds of incident fracture in women and with a 6-fold increased odds in men.² The findings from the Study of Osteoporotic Fractures¹ underscore the significance of . . . [Full Text of this Article]

Elizabeth J. Samelson, PhD, MPH
samelson@hrca.harvard.edu

Douglas P. Kiel, MD, MPH
Institute for Aging Research
Hebrew SeniorLife
Boston, Massachusetts

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