2009 Age + Prize Winner: Meghan Donaldson

Estimates of the proportion of older white women who would be recommended for pharmacologic treatment by the new U.S. National Osteoporosis Foundation Guidelines.

Management of osteoporosis in Canada is strongly influenced by US guidelines. Substantial revisions to the US National Osteoporosis Foundation (NOF) treatment guidelines occurred in 2008. This research was conducted as it was determined that the new guidelines would substantially increase recommendations for pharmacologic treatment, particularly among women with osteopenia and high probability of fracture. There is limited evidence to suggest that this group of women benefit from anti-fracture treatments.

The Study of Osteoporotic Fractures (SOF) is a cohort of nearly 10,000 Caucasian women aged 65 and older enrolled in four centers in the United States. SOF participants completed a series of questionnaires at baseline to obtain relevant information about their health history. Additionally, they had their bone density measured at the hip and spine. Data were analyzed to determine the effect of the new NOF guidelines.

This research highlighted the large proportion of women that would be recommended for osteoporosis drug treatment. The anti-fracture benefit is unknown for the majority of these women. This research led to a recalculation of the FRAX 10-year probability of fracture for the US Caucasian population. These revised estimates are lower than the original ones and will decrease the proportion of women who would be treated.

This research project was Meghan's first opportunity to research risk prediction for fracture outcomes in seniors. It provided her experience in working with the world's largest fracture database using the new World Health Organization fracture prediction model called FRAX. This gave Meghan expertise in being able to extract important health data from this valuable resource. Meghan will now apply this analytic tool to various research questions in the older population.

Meghan is currently a postdoctoral fellow at the San Francisco Coordinating Center working with Dr. Steven Cummings. She will hold this position until February 2011, after which she plans to pursue an academic research career with a focus on mobility and ageing.