Multidimensional Health Evaluation of Older Adults in a Tertiary Care Fragility Fracture Clinic: Insights from a Geriatric Assessment-based Approach

Background: Fragility fractures are a significant concern for older adults, leading to disability and healthcare use. This study evaluated the relationship between comprehensive geriatric assessment (CGA) and 10-year fracture risk in fragility clinic. Materials and Methods: This cross-sectional study of 200 individuals aged 60+ was conducted between February 2017 and October 2018. CGA included assessments of frailty (Rockwood’s Frailty Index), cognition (Hindi-Mental State Examination), mood (Geriatric Depression Scale), nutrition (Mini Nutritional Assessment), gait and balance (Timed Up and Go [TUG] test), sensory function, urinary incontinence, functional status (basic activities of daily living/instrumental activities of daily living), and fall history. The fracture risk assessment tool estimated 10-year fracture risk. Results: The mean age was 67.6 years, with 75% women. Polypharmacy was present in 62%, depression in 63%, and frailty in 20%. Unadjusted analyses showed that recent falls, frailty, impaired daily functioning, and abnormal TUG were linked to higher fracture risk. After adjustments, polypharmacy was associated with a lower risk of fractures (β = −1.48; 95% confidence interval [CI] −2.76 to −0.20; P = 0.023), possibly reflecting differences in medication classes or greater healthcare access and monitoring in this group. Vision impairment was linked to higher fracture risk (major osteoporotic fractures: β = 4.16; 95% CI 0.38–7.94 P = 0.031; hip fractures: β = 2.61; 95% CI 0.11–5.09; P = 0.040). Abnormal TUG performance showed a potential lower risk (β = −1.66; 95% CI − 3.28 to − 0.04; P = 0.045), though this may reflect test limitations. Conclusion: This study suggests that incorporating CGA-based evaluations into fracture risk assessments can identify at-risk individuals and guide preventive strategies.