Leslie WD, Morin SN, Lix LM, et al. - Through a study population of 24,943 women and men aged 40 years and older with fracture probability assessment (FRAX), self-reported falls for the former year (categorized as none, 1, 2, or > 3) and fracture outcomes, researchers investigated the independent impacts of falls on subsequent fractures in a large clinical registry of bone mineral density (BMD) results for the Province of Manitoba, Canada that had been systematically gathering self-reported falls information since September 1, 2012. Eight hundred and sixty-three, 212 and, 1,210 sustained one or more major osteoporotic fractures (MOF), sustained a hip fracture and sustained any incident fracture, respectively. A gradient of progressing risk for fracture with an increasing number of falls was noted in comparison with no falls in the previous year. Results exhibited minimal attenuation with covariate adjustment. When adjusted for baseline fracture probability (FRAX score with BMD), the HR for MOF progressed from 1.49 to 1.74 and 2.62 for one fall, two falls and for ≥ 3 falls, respectively. HRs were comparable for any incident fracture and slightly bigger for prognostication of hip fracture, reaching 3.41 for ≥ 3 previous falls. Therefore, in the routine clinical practice setting, the self-report number of falls in the previous year was strongly correlated with incident fracture risk, and this risk was independent of age, sex, BMD, and baseline fracture likelihood. Furthermore, there is dose-response with multiple falls (up to a maximum of 3) presenting a bigger risk than those with a single fall.