Bone mass cannot be predicted by estimations of frailty in elderly ambulatory women
Bone mass cannot be predicted by estimations of frailty in elderly ambulatory women
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DOI：
10.1159/000069169
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发表时间：
2003-05-01
期刊：
影响因子：
3.5
通讯作者：
Åkesson, K
中科院分区：
文献类型：
--
作者：
Gerdhem, P;Ringsberg, KAM;Åkesson, K
背景/方法：在随机选择的 993 名 75 岁女性中，对高生物学年龄或虚弱（脆性骨折的可能危险因素）及其与已知骨折危险因素（低骨密度（BMD）、低肌肉力量、步态表现差和平衡能力差、既往跌倒、既往骨折和未来跌倒风险）的关系进行了调查。虚弱没有公认的定义，在这里被定义为对个人总体健康状况的主观直接印象，并被转化为任意量表。 993 个人至少由四名观察员之一进行评分。结果：衰弱评分与 BMD 不相关。高虚弱评分与不良步态（r = 0.53-0.59，p < 0.0001）、平衡能力差（r = -0.49，p < 0.0001）、低肌肉力量（r = -0.25 至 -0.41，p < 0.0001）、低活动水平（r = -0.43，p < 0.0001）和高风险显着相关。失败（r = 0.24，p < 0.0001）。与那些没有经历过跌倒的女性相比，去年至少经历过一次跌倒的女性群体的虚弱评分更高 (p < 0.0001)。 70 岁以后发生髋部或股骨骨折的女性比没有发生过骨折的女性的虚弱评分更高。结论：不能通过我们的主观虚弱评分来预测老年、活动女性的骨量。由于高虚弱评分与影响或可能影响跌倒倾向的因素相关，这可能表明高虚弱评分是骨折的危险因素，与骨量无关。虚弱可能被视为一个复杂的风险因素，包括多项可以客观衡量的评估。衰弱评估是否是一种改善对脆性骨折风险患者评估的方法尚未得到证实，只能在骨折发生的前瞻性研究中得到证实。版权所有 (C) 2003 S. Karger AG，巴塞尔。
Background/Methods: High biological age, or frailty, a possible risk factor for fragility fracture, and its relation to known risk factors for fracture (low bone mineral density (BMD), low muscle strength, poor gait performance and poor balance, previous falls, previous fractures and future risk of falls) were investigated in 993 randomly selected 75-year-old women. Frailty, which has no accepted definition, was here defined as a subjective immediate impression of an individual's general health appearance and was transferred into an arbitrary scale. 993 individuals were scored by at least one of four observers. Results: The frailty score and BMD were not correlated. A high frailty score was significantly correlated to poor gait (r = 0.53-0.59, p < 0.0001), poor balance (r = -0.49, p < 0.0001), low muscle strength (r = -0.25 to -0.41, p < 0.0001), low activity level (r = -0.43, p < 0.0001) and a high risk of failing (r = 0.24, p < 0.0001). The group of women who had experienced at least one fall the previous year had a higher frailty score (p < 0.0001) compared to those who had not. Women who had sustained a hip or femoral fracture after the age of 70 had a higher frailty score than women with no earlier fracture at all. Conclusions: Bone mass cannot be predicted by our subjective frailty score in elderly, ambulant women. Since a high frailty score correlates with factors that affect or are likely to affect fall propensity, this could indicate that a high frailty score is a risk factor for fracture, independent of bone mass. Frailty may be regarded as a complex risk factor, including several assessments that can be objectively measured. Whether estimation of frailty is a method to improve the assessment of the patient at risk for a fragility fracture is yet to be proven and can only be shown in a prospective study of fracture occurrence. Copyright (C) 2003 S. Karger AG, Basel.