Document Type

Journal Article

Publication Title

GeroScience

Publisher

Springer

School

Nutrition and Health Innovation Research Institute / School of Medical and Health Sciences / Centre for Artificial Intelligence and Machine Learning (CAIML) / School of Science

RAS ID

78271

Funders

Rady Innovation Fund / Rady Faculty of Health Sciences / University of Manitoba / Medical Research Future Fund Cardiovascular Health Mission (2024225) / Royal Perth Hospital Research Foundation Fellowship / Western Australian Future Health Research and Innovation Fund / Raine Medical Research Foundation / National Heart Foundation Future Leader Fellowship (102817)

Comments

Sim, M., Gebre, A. K., Dalla Via, J., Reid, S., Jozani, M. J., Kimelman, D., ... & Leslie, W. D. (2025). Automated abdominal aortic calcification scoring from vertebral fracture assessment images and fall-associated hospitalisations: The Manitoba Bone Mineral Density Registry. GeroScience. Advance online publication. https://doi.org/10.1007/s11357-025-01589-7

Abstract

Abdominal aortic calcification (AAC), a subclinical measure of cardiovascular disease (CVD) that can be assessed on vertebral fracture assessment (VFA) images during osteoporosis screening, is reported to be a falls risk factor. A limitation to incorporating AAC clinically is that its scoring requires trained experts and is time-consuming. We examined if our machine learning (ML) algorithm for AAC (ML-AAC24) is associated with a higher fall-associated hospitalisation risk in the Manitoba Bone Mineral Density (BMD) Registry. A total of 8565 individuals (94.0% female, age 75.7 ± 6.8 years) who had a BMD and VFA image from DXA between February 2010 and December 2017 were included. ML-AAC24 was categorised based on established categories (ML-AAC24 = low < 2; moderate 2 to < 6; high ≥ 6). Cox proportional hazards models assessed the relationship between ML-AAC24 categories and incident fall-associated hospitalisations obtained from linked health records (mean ± SD follow-up, 3.9 ± 2.2 years). Individuals with moderate (9.6%) and high ML-AAC24 (11.7%) had a greater proportion of fall-associated hospitalisations, compared to those with low ML-AAC24 (6.0%). In age and sex-adjusted models, compared to low ML-AAC24, moderate (HR 1.49, 95% CI 1.24–1.79) and high ML-AAC24 (HR 1.89, 95% CI 1.56–2.28) were associated with greater hazards for a fall-associated hospitalisation. Results were comparable (HR 1.37, 95% CI 1.13–1.65 and HR 1.60, 95% CI 1.31–1.95, respectively) after multivariable adjustment, including prior falls and CVD, as well as medication use. Integrating ML-AAC24 into bone density machine software to identify high risk individuals would opportunistically provide important information on fall and cardiovascular disease risk to clinicians for evaluation and intervention.

DOI

10.1007/s11357-025-01589-7

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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Link to publisher version (DOI)

10.1007/s11357-025-01589-7