Document Type

Journal Article

Publication Title

BMJ open





First Page


PubMed ID



BMJ Publishing Group


Institute for Nutrition Research / School of Medical and Health Sciences




Osteoporosis Australia / New Zealand Bone and Mineral Society / Royal Perth Hospital Research Foundation Career Advancement Fellowship (130/2020), Emerging Leader Fellowship / Western Australian Future Health Research and Innovation Fund / NHMRC InvestigatorGrant (GNT1174886, GNT9000320) / National Heart Foundation of Australia, Future Leader Fellowship / Faculty of Medicine, Nursing and Health Sciences, Monash University

Grant Number

NHMRC Numbers : GNT9000320, GNT1174886

Grant Link


Zengin, A., Shore-Lorenti, C., Sim, M., Maple-Brown, L., Brennan-Olsen, S. L., Lewis, J. R., ... & Ebeling, P. (2022). Why Aboriginal and Torres Strait Islander Australians fall and fracture: the codesigned Study of Indigenous Muscle and Bone Ageing (SIMBA) protocol. BMJ open, 12(4), e056589.


OBJECTIVES: Aboriginal and Torres Strait Islander Australians have a substantially greater fracture risk, where men are 50% and women are 26% more likely to experience a hip fracture compared with non-Indigenous Australians. Fall-related injuries in this population have also increased by 10%/year compared with 4.3%/year in non-Indigenous Australians. This study aims to determine why falls and fracture risk are higher in Aboriginal and Torres Strait Islander Australians. SETTING: All clinical assessments will be performed at one centre in Melbourne, Australia. At baseline, participants will have clinical assessments, including questionnaires, anthropometry, bone structure, body composition and physical performance tests. These assessments will be repeated at follow-up 1 and follow-up 2, with an interval of 12 months between each clinical visit. PARTICIPANTS: This codesigned prospective observational study aims to recruit a total of 298 adults who identify as Aboriginal and Torres Strait Islander and reside within Victoria, Australia. Stratified sampling by age and sex will be used to ensure equitable distribution of men and women across four age-bands (35-44, 45-54, 55-64 and 65+ years). PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome is within-individual yearly change in areal bone mineral density at the total hip, femoral neck and lumbar spine assessed by dual energy X-ray absorptiometry. Within-individual change in cortical and trabecular volumetric bone mineral density at the radius and tibia using high-resolution peripheral quantitative computed tomography will be determined. Secondary outcomes include yearly differences in physical performance and body composition. ETHICAL APPROVAL: Ethics approval for this study has been granted by the Monash Health Human Research Ethics Committee (project number: RES-19-0000374A). TRIAL REGISTRATION NUMBER: ACTRN12620000161921.



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Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License