Epidemiological Survey of Quantitative Ultrasound in Risk Assessment of Falls in Middle-Aged and Elderly People

Abstract

The risk assessment of falls is important, but still unsatisfactory and time-consuming. Our objective was to assess quantitative ultrasound (QUS) in the risk assessment of falls. Our study was designed as epidemiological cross-sectional study occurring from March 2009 to February 2010 by community survey at a medical center. The participants were collected from systemic sample of 1,200 community-dwelling people (Male/Female = 524/676) 40 years old and over in Yunlin County, Mid-Taiwan. Structural questionnaires including socioeconomic status, living status, smoking and drinking habits, exercise and medical history were completed. Quantitative ultrasound (QUS) at the non-dominant distal radial area (QUS-R) and the left calcaneal area (QUS-C) were measured. The overall prevalence of falls was 19.8%. In men, the independently associated factors for falls were age (OR: 1.04; 95%CI: 1.01∼1.06), fracture history (OR: 1.89; 95%CI: 1.12∼3.19), osteoarthritis history (OR: 3.66; 95%CI: 1.15∼11.64) and speed of sound (OR: 0.99; 95%CI: 0.99∼1.00; p<0.05) by QUS-R. In women, the independently associated factors for falls were current drinking (OR: 3.54; 95%CI: 1.35∼9.31) and broadband ultrasound attenuation (OR: 0.98; 95%CI: 0.97∼0.99; p<0.01) by QUS-C. The cutoffs at -2.5< T-score<-1 derived using QUS-R (OR: 2.85; 95%CI: 1.64∼4.96; p<0.01) in men or T-score ≦-2.5 derived using QUS-C (OR: 2.72; 95%CI: 1.42∼5.21; p<0.01) in women showed an independent association with falls. The lowest T-score derived using either QUS-R or QUS-C was also revealed as an independent factor for falls in both men (OR: 2.13; 95%CI: 1.03∼4.43; p<0.05) and women (OR: 2.36; 95%CI: 1.13∼4.91; p<0.05). Conclusions: Quantitative ultrasounds, measured either at the radial or calcaneal area, are convenient tools by which to assess the risk of falls in middle-aged and elderly people.

Risco de quedas em idosos residentes na comunidade: revisão sistemática da literatura

“…Of the 62 articles included in this review, 60% were published in 2012 (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34) and 2013 (35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52) . The articles are from 15 different countries, but especially from the United States of America (18)(19)(24)(25)30,33,39,(53)(54)(55)(56)(57)(58)(59)…”

“…The other countries with most articles were Canada (23,29,40,(65)(66)(67)(68) with seven, Netherlands (20,31,35,51,69) with five, and United Kingdom (48,(70)(71)(72) with four. Then came China (26,50,73) , France (45,49,74) and Sweden (37)(38)41) , with two, Ireland (75)(76) with one, and Germany (21) , Brazil (16) , Korea (26) , Spain (77) , Japan (22) , and Thailand (43) . Six of the selected studies are secondary (systematic literature reviews) and the remaining 56 are primary studies based on quantitative methodology, i.e.…”

“…Age ≥ 65 years (50,61,63,73,74,77) 6 √ History of falls (28,50,53,57,63,67,69) 7 √ Living alone (63) 1 √ Lower limb prosthesis 0 √ Use of assistive devices (e.g. walker, cane, wheelchair) (17,41) 2 √ Female (20,38,40,59,63,73,74,77) 8…”

“…Change of blood sugar (27)(28)68) 3 √ Arthritis (50,65) 2 √ Diminished strength of the lower extremities (28,31,46,52) 4 √ Diarrhoea 0 √ Difficulty in gait (16,21,(23)(24)28,32,37,46,(59)(60)63,69,75) 13 √…”

Instrumentos para evaluación del riesgo de caídas en los ancianos residentes en la comunidad

“…De los 24 artículos que integran la muestra, seis fueron publicados en 2011 (16,18,21,31,(34)(35) , cuatro en 2012 (24)(25)33,38) , once en 2013 (17,(19)(20)(22)(23)(27)(28)(29)(30)32,39) y tres en 2014 (26,36,37) . En cuanto al país de origen de los estudios, los Estados Unidos (19,21,25,31,33,35,37) y Australia (17)(18)27,38) representan el mayor número de estudios, con siete y cuatro, respectivamente, seguido de Canadá (22,24,29) y Reino Unido, con tres estudios (26,34,36) .…”