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Fracture predictive ability of physical performance tests and history of falls in elderly women: a 10-year prospective study

Wihlborg, A.; Englund, M.; Åkesson, Kristina LU and Gerdhem, P. (2015) In Osteoporosis International 26(8). p.2101-2109
Abstract
A Summary In a large cohort of elderly women followed for 10 years, we found that balance, gait speed, and self-reported history of fall independently predicted fracture. These clinical risk factors are easily evaluated and therefore advantageous in a clinical setting. They would improve fracture risk assessment and thereby also fracture prevention. Introduction The aim of this study was to identify additional risk factors for osteoporosis-related fracture by investigating the fracture predictive ability of physical performance tests and self-reported history of falls. Methods In the population-based Osteoporosis Prospective Risk Assessment study (OPRA), 1044 women were recruited at the age of 75 and followed for 10 years. At inclusion,... (More)
A Summary In a large cohort of elderly women followed for 10 years, we found that balance, gait speed, and self-reported history of fall independently predicted fracture. These clinical risk factors are easily evaluated and therefore advantageous in a clinical setting. They would improve fracture risk assessment and thereby also fracture prevention. Introduction The aim of this study was to identify additional risk factors for osteoporosis-related fracture by investigating the fracture predictive ability of physical performance tests and self-reported history of falls. Methods In the population-based Osteoporosis Prospective Risk Assessment study (OPRA), 1044 women were recruited at the age of 75 and followed for 10 years. At inclusion, knee extension force, standing balance, gait speed, and bone mineral density (BMD) were examined. Falls the year before investigation was assessed by questionnaire. Cox proportional hazards regression analysis was used to determine fracture hazard ratios (HR) with BMD, history of fracture, BMI, smoking habits, bisphosphonate, vitamin D, glucocorticoid, and alcohol use as covariates. Continuous variables were standardized and HR shown for each standard deviation change. Results Of all women, 427 (41 %) sustained at least one fracture during the 10-year follow-up. Failing the balance test had an HR of 1.98 (1.18-3.32) for hip fracture. Each standard deviation decrease in gait speed was associated with an HR of 1.37 (1.14-1.64) for hip fracture. Previous fall had an HR of 1.30 (1.03-1.65) for any fracture; 1.39 (1.08-1.79) for any osteoporosis-related fracture; and 1.60 (1.03-2.48) for distal forearm fracture. Knee extension force did not show fracture predictability. Conclusion The balance test, gait speed test, and self-reported history of fall all hold independent fracture predictability. Consideration of these clinical risk factors for fracture would improve the fracture risk assessment and subsequently also fracture prevention. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Clinical risk factor, Fracture, Fracture risk assessment, Osteoporosis, Physical performance test
in
Osteoporosis International
volume
26
issue
8
pages
2101 - 2109
publisher
Springer
external identifiers
  • wos:000358040800006
  • scopus:84938971396
ISSN
1433-2965
DOI
10.1007/s00198-015-3106-1
language
English
LU publication?
yes
id
cc2c177a-2051-4448-9c64-009f25a94b1b (old id 7779806)
date added to LUP
2015-09-01 16:08:08
date last changed
2017-07-09 04:12:06
@article{cc2c177a-2051-4448-9c64-009f25a94b1b,
  abstract     = {A Summary In a large cohort of elderly women followed for 10 years, we found that balance, gait speed, and self-reported history of fall independently predicted fracture. These clinical risk factors are easily evaluated and therefore advantageous in a clinical setting. They would improve fracture risk assessment and thereby also fracture prevention. Introduction The aim of this study was to identify additional risk factors for osteoporosis-related fracture by investigating the fracture predictive ability of physical performance tests and self-reported history of falls. Methods In the population-based Osteoporosis Prospective Risk Assessment study (OPRA), 1044 women were recruited at the age of 75 and followed for 10 years. At inclusion, knee extension force, standing balance, gait speed, and bone mineral density (BMD) were examined. Falls the year before investigation was assessed by questionnaire. Cox proportional hazards regression analysis was used to determine fracture hazard ratios (HR) with BMD, history of fracture, BMI, smoking habits, bisphosphonate, vitamin D, glucocorticoid, and alcohol use as covariates. Continuous variables were standardized and HR shown for each standard deviation change. Results Of all women, 427 (41 %) sustained at least one fracture during the 10-year follow-up. Failing the balance test had an HR of 1.98 (1.18-3.32) for hip fracture. Each standard deviation decrease in gait speed was associated with an HR of 1.37 (1.14-1.64) for hip fracture. Previous fall had an HR of 1.30 (1.03-1.65) for any fracture; 1.39 (1.08-1.79) for any osteoporosis-related fracture; and 1.60 (1.03-2.48) for distal forearm fracture. Knee extension force did not show fracture predictability. Conclusion The balance test, gait speed test, and self-reported history of fall all hold independent fracture predictability. Consideration of these clinical risk factors for fracture would improve the fracture risk assessment and subsequently also fracture prevention.},
  author       = {Wihlborg, A. and Englund, M. and Åkesson, Kristina and Gerdhem, P.},
  issn         = {1433-2965},
  keyword      = {Clinical risk factor,Fracture,Fracture risk assessment,Osteoporosis,Physical performance test},
  language     = {eng},
  number       = {8},
  pages        = {2101--2109},
  publisher    = {Springer},
  series       = {Osteoporosis International},
  title        = {Fracture predictive ability of physical performance tests and history of falls in elderly women: a 10-year prospective study},
  url          = {http://dx.doi.org/10.1007/s00198-015-3106-1},
  volume       = {26},
  year         = {2015},
}