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Background/Aims The occurrence of hip and vertebral fragility fractures has been linked to increased mortality; possible explanations including fracture complications and multi-morbidity. Given the advances in osteoporosis management in recent years, and the time since this subject was last studied, we aimed to examine associations between previous fracture and mortality, and specifically to consider whether sexual dimorphism in relationships existed, using a UK community dwelling cohort of older adults (Hertfordshire Cohort Study), linked to death registers. Methods 2997 (1579 men and 1418 women) participants were included in the study. At baseline, participants self-reported history of fractures and a subset (n = 992) underwent hip bone mineral density (BMD) assessment. Median follow-up time for mortality was 16.2 years. Previous fracture since age 45 years (any and minor trauma) and femoral neck BMD in relation to all-cause and cause-specific mortality (cancer, cardiovascular and other) were examined separately, using sex-specific Cox proportional hazards models, with and without adjustment for age. Results The mean (SD) age of participants at baseline was 65.7 (2.9) years for men and 66.6 (2.7) for women. 575 (36.4%) men and 365 (25.7%) women died over the follow up study period. 230 (14.6%) men and 155 (10.9%) women died from cancer and, 169 (10.7%) men and 70 (4.9%) women from cardiovascular diseases. 174 (11.0%) men and 138 (9.7%) women died from other causes. Among men who died from other causes, the most common conditions leading to death were dementia (9.2%), bronchopneumonia (8.1%) and Parkinson’s disease (7.5%); corresponding conditions for women were Alzheimer's disease (11.6%), pneumonia (9.4%) and dementia (8.0%). In women, mortality associated with diseases other than cardiovascular disease or cancer was increased significantly in the presence of a previous fracture since the age of 45 (unadjusted hazard ratio: 1.47, 95% CI: 1.01,2.15, p = 0.04) and minor trauma fracture (1.67, 95% CI: 1.14,2.46, P = 0.01); association regarding minor trauma fracture was robust to adjustment for age (p = 0.04). In men, a history of fracture since the age of 45 was associated with increased cancer-related mortality with and without adjustment for age (1.42, 95% CI: 1.01, 1.99, P = 0.04 without age-adjustment). Baseline BMD was not associated with increased mortality from any cause in either sex. Conclusion Our study has highlighted different associations between fracture and mortality in men and women, possibly suggesting different pathogenesis of fracture in the two sexes. Work in other large cohorts with linked mortality data might seek to replicate and further explore these associations. Disclosure F. Laskou: None. L. Westbury: None. H. Patel: None. C. Cooper: None. E. Dennison: None.

P134 Mortality rates in individuals with a history of fracture: does sex matter? Findings from the Hertfordshire Cohort Study UK