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Electronic Supplementary Material 3

Table Number of women with incident fractures. Number of fractures and incidence rate stratified by frailty status at age 75 and calculated after 1- and 2 years

No. of women with at least one fracturea No. of fracturesb Incidence rate ratio

Non-frail Frail

Non-frail Frail

Frailty status at age 75 n=799 n=245 P-value

Fractures in the 1-year between 75-76 No (%) No (%) No (fractures/1000

person-years)c

No (fractures/1000 person-years)c

IRRd

Any1 36 (4.5) 17 (6.9) 0.129 42 (52.9) 22 (91.9) 1.74 (0.99-2.98)

Major osteoporotic3 27 (3.4) 14 (5.7) 0.100 35 (44.1) 18 (75.2) 1.71 (0.91-3.09)

Hip 5 (0.6) 6 (2.4) 0.014 5 (6.3) 6 (25.0) 3.98(1.01-16.48)

Vertebral4 11 (1.4) 4 (1.6) 0.769 14 (17.6) 7 (29.2) 1.66 (0.57-4.39)

Fractures in the 2-years between 75-77 No (%) No (%) No (fractures/1000

person-years)

No (fractures/1000 person-years)

IRR

Any 63 (7.9) 31 (13.1) 0.014 72 (45.6) 42 (82.2) 1.80 (1.20-2.67)

Major osteoporotic 46 (5.8) 26 (10.6) 0.009 54 (34.2) 36 (70.5) 2.05 (1.31-3.20)

Hip 12 (1.5) 11 (4.5) 0.005 12 (7.6) 11 (21.5) 2.83(1.13-7.01)

Vertebral 14 (1.8) 8 (3.3) 0.149 18 (11.4) 14 (27.4) 2.40 (1.11-5.11)

Frailty Index (mean, SD) 0.14 (0.05) 0.36 (0.10)

aFirst fracture used as endpoint. A woman could be included in multiple categories if fractures at different sites were sustained during the follow-up. bMultiple fractures in the same woman are included in the count. cIncidence rate (IR). dIncidence Rate Ratio (reference non-frail).

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Title: In community-dwelling women frailty is associated with imminent risk of osteoporotic fractures

Osteoporosis International

Patrik Bartosch

1

, Linnea Malmgren

1,2

, Jimmie Kristensson

3,4, Fiona E McGuigan1

, Kristina E Akesson

1

Affiliation of authors

1

Lund University, Department of Clinical Sciences Malmö, Clinical and Molecular Osteoporosis Research Unit; Skåne University Hospital, Department of Orthopaedics, Malmö, Sweden

2

Skåne University Hospital, Department of Geriatrics, Malmö, Sweden

3

Lund University, Department of Health Sciences, Proactive an integrated care research unit

4

Lund University & Region of Skåne, Institute for Palliative Care

Corresponding author:

Professor Kristina Åkesson, MD, PhD Email: kristina.akesson@med.lu.se

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1 Lund University, Department of Clinical Sciences Malmö, Clinical and Molecular Osteoporosis Research Unit; Skåne University Hospital, Department of Orthopaedics, Malmö, Sweden.