Deprivation indices and their association with fragility fractures and bone density: evidence from a large observational cohort
Authors' conclusion
Socioeconomic deprivation is independently associated with increased fracture odds, osteoporosis and high fragility fracture risk-related body composition.
Study context
- Population
- Patients aged ≥50 years undergoing DXA scanning, June 2004–May 2025, northwest England29,693 analysed
- Participants
- 40,951 patients
- Exposure
- Most vs less socioeconomically deprived patients
- Outcome
- Major osteoporotic fractures (MOFs) and hip fractures (HFs); also bone density and body composition
Methodological detailsgeneralised additive models, adjusted for FRAX risk factors
- Generalised additive models
- Adjusted for FRAX risk factors
Main finding
As reported in the abstract
Fracture odds by deprivation
MOF, most deprived (Index of Multiple Deprivation (IMD)): OR
1.07 (1.02-1.14) (95% CI)
HF, most deprived (IMD): OR
1.28 (1.11-1.46) (95% CI)
MOF, Townsend Deprivation Score (TDS): OR
1.10 (1.03-1.18) (95% CI)
Observational data: associations, not effects.
Further findings
Osteoporosis odds
- TDS, femoral neck: OR
- 1.45 (1.33-1.59) (95% CI)
- TDS, lumbar spine: OR
- 1.30 (1.19-1.29) (95% CI)
- IMD, femoral neck: OR
- 1.34 (1.24-1.45) (95% CI)
- IMD, lumbar spine: OR
- 1.20 (1.13-1.29) (95% CI)
Regional body fat in deprived patients
- TDS: higher femoral fat
- 0.90%
- TDS: higher abdominal fat
- 0.84%
- IMD: higher femoral fat
- 0.60%
- IMD: higher abdominal fat
- 0.67%
Original publication
Deprivation indices and their association with fragility fractures and bone density: evidence from a large observational cohort. Rheumatology (Oxford). Published 17 October 2025. doi:10.
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