Prediction of hip fracture in elderly women: a prospective study.

Abstract

Main outcome measures-Broad band ultrasonic attenuation (BUA) index, Clifton assessment procedures for the elderly test (for cognisance), and mobility on a six point scale, and fracture of the hip in the subsequent two year period.Results-73 Women fractured their hip during the two years. Their mean age was not significantly different from that of the women who did not have a fracture (85.3 (SD 5.6) v 83-9 (6.3); p=0.07), but their mean BUA index (40.3 (19-3) v 50*9 (22.2) db/MH2), and score for cognisance (median 19 (interquartile range 10-5-27-0) v 24 (17-30)) were significantly lower (both p<0001). These variables had independent associations with fracture of the hip. Women with fractures had a significantly lower score for the psychomotor component of the cognisance test (4.5 (1-8) v 7 (2-10); p<0.0025 and were significantly more mobile (1 (1-3) v 3 (1-6); p<002). Subdividing women according to high, medium, and low scores for BUA index and cognisance testing disclosed a high risk group (118 women) with low BUA index and cognisance score, whose incidence offracture was 12-8%; in the group at lowest risk (136 women) with high BUA index and cognisance score, the incidence of fracture was only 1-5% (relative risk (95% confidence interval -2-0 to 35.5)). Further analysis showed that those most at risk were, additionally, most mobile but that less mobile women with good cognisance had a low incidence of fractures, regardless of the BUA index, (1-2%, high index, v 0 9%, low index).Conclusions-Elderly women most at risk of sustaining hip fractures were those with low BUA index, low cognisance test score, and high mobility.

Análise dos fatores associados a quedas com fratura de fêmur em idosos: um estudo caso-controle

“…6 Projeções futuras apontam que, no ano de 2050, seis milhões de pessoas sofrerão fratura de fêmur. 7 Diante do exposto e da relevância do tema, o presente estudo teve como objetivo identificar os principais fatores associados a quedas e fraturas de fêmur em idosos em um município do sudeste brasileiro.…”

Osteoporotic fractures of proximal femur: clinical and epidemiological features in a population of the city of São Paulo

“…2,3 The incidence of these fractures has doubled in the last 25 years and it is estimated that 6,000,000 individuals in the world will suffer fracture of the proximal femur in 2050. 4 As the elderly population continues to increase, this fracture is regarded as an orthopedic epidemic. 2 This results in cost increases for various countries and it therefore represents a great social and economic problem.…”

The Influence of Physical Activity and Fractures on Ultrasound Parameters in Elderly People

“…Ultrasound parameters are associated with bone mass and may supply information about the structure of bone tissue as well, which is another major component of bone strength [9]. Several studies suggest that ultrasound measurements at the calcaneus may be useful for estimating fracture risk [10,11].…”