Abstract Ref: 

Clare A. Tracey1, Michelle M. Clarke2, Catherine F. Hughes3, Vivian Bruls4, Jan Rigby5,
Helene McNulty3, Miriam C. Casey6, Conal Cunningham7, Fergal Tracey8,
Kevin McCarroll7, Leane Hoey3, Mary Ward3, J.J. Strain3, Anne M. Molloy9,
Adrian Moore10
1School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast,
United Kingdom
2School of Agriculture & Food Science, University College Dublin, Dublin, Ireland
3Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, United
4Department of Epidemiology, Maastricht University, Maastricht, Netherlands
5National Centre for GeoComputation, Maynooth University, Maynooth, Ireland, Maynooth,
6Mercer’s Institute for Research on Ageing, St. James’s Hospital, Dublin, Ireland
7Mercer’s Institute for Research on Ageing, St. James’s Hospital, Dublin, Ireland
8Causeway Hospital, Northern Health and Social Care Trust, Coleraine, United Kingdom
9Institute of Molecular Medicine, School of Medicine, Trinity College Dublin, Dublin, Ireland
10School of Environmental Sciences, Ulster University, Coleraine, United Kingdom

Background: Osteoporosis poses major health, economic and social consequences
which adversely impact on the lives of older people and society. To date, there is a lack of
literature examining the relationship between area level socioeconomic deprivation and
bone health, and existing evidence has been inconsistent. This study aims to investigate
the association between area-based socioeconomic deprivation and osteoporosis in older
people living across Ireland.

Methods: This was a retrospective observational study in 3,338 participants recruited
from Northern Ireland (n = 1,994) and the Republic of Ireland (n = 1344) to the Trinity,
Ulster and Department of Agriculture (TUDA) study. Bone mineral density (BMD) was
assessed using dual-energy X-ray absorptiometry (DXA). Using geo- referenced address
based information, participants were mapped and linked to official socioeconomic indicators
of deprivation for Northern Ireland and the Republic of Ireland. Each participant
was assigned a deprivation score relating to the smallest administrative area in which they
lived and scores were categorised into quintiles from least to most deprived.

Results: Some 22% of the total cohort resided within the most deprived areas of Ireland
(quintile 5). Compared to all other quintiles, these individuals had the greatest incidence
of osteoporosis at the hip. Within Northern Ireland, participants living in an area of
greatest deprivation (quintile 5) had a two-fold greater risk of osteoporosis (OR 2.171; CI
1.241, 3.799; p = 0.007) after adjustment for relevant covariates. However, no significant
association was observed in the Republic of Ireland cohort.

Conclusion: The results of this study show that area-based socioeconomic deprivation is
a risk factor for osteoporosis in older adults. These findings warrant further investigation
into the contributing factors involved in the development of osteoporosis so that appropriate
strategies can be developed to alleviate this risk in individuals living in the areas
with the greatest levels of deprivation.