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Hip Fracture Prediction by Combining Fall Risk, Impact Loads and Bone Strength

通过结合跌倒风险、冲击载荷和骨强度来预测髋部骨折

基本信息

批准号：
10176353
负责人：
Fjola Johannesdottir
金额：
$ 8.75万
依托单位：
BETH ISRAEL DEACONESS MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-06-15 至 2023-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10176353
关键词：
Address Affect Age Assessment tool Attenuated Biomechanics Bone Density Characteristics Clinical Clinical Research Cohort Studies Communities Data Development Dual-Energy X-Ray Absorptiometry Elderly Enrollment Equilibrium Etiology Fall prevention Finite Element Analysis Fracture Future Gait speed Goals Growth Health Height Hip Fractures Hip region structure Hospitals Image In Vitro Individual Injury Intervention Knee Knowledge Lead Nursing Homes Odds Ratio Older Population Osteoporosis Patients Pharmaceutical Preparations Population Prevention strategy Probability Recording of previous events Research Design Risk Assessment Risk Factors Role Scanning Testing Thick Vision Weight Woman Work X-Ray Computed Tomography base bone strength clinical risk cohort cost fall risk falls follow-up fracture risk high risk improved men neuromuscular function novel strategies older men older women osteoporosis with pathological fracture population based prospective sex skeletal soft tissue therapy design tool

项目摘要

Project Summary Hip fractures remain one of the most devastating and costly clinical problem affecting older adults. Each year over 300,000 older people sustain hip fracture in the U.S., up to 25% of hip fracture patients die within a year of their injury, and hip fractures account for ~72% of the overall $17 billion cost for osteoporotic fractures. The current clinical standard for assessment of fracture risk is bone mineral density (BMD) testing by dual-energy x-ray absorptiometry (DXA) combined with clinical risk factors. However, half of all fractures occur in those who do not have osteoporosis by BMD testing and/or who have few clinical risk factors, and thus do not meet the WHO fracture risk assessment tool (FRAX) intervention thresholds. Despite the fact that >90% all hip fractures are due to a fall, the current approaches of hip fracture risk do not directly include the probability of falling or the skeletal loading that likely occurs during fall. Our overall goal is to improve the prediction of hip fracture risk by using a biomechanical framework that accounts for the risk of falling, the impact loading due to a fall and femoral strength. In a prospective case-cohort study of 3500 older adults from the AGES Reykjavik study we will develop a subject-specific fall risk tool to evaluate the probability of falling from baseline data including age, sex, fall history, neuromuscular function, dynamic balance, vision and medication use to predict fall occurrence at follow-up (Aim 1). Furthermore, in a prospective case-cohort study of 698 cases and 2792 controls from the AGES-Reykjavik cohort we will test whether a biomechanical approach that compares subject-specific forces applied to the hip during a sideways fall to femoral strength and accounts for subject-specific probability of falling improves hip fracture prediction beyond the current clinical standard (Aim 2). This project will have high impact, as the results will lead to better understanding of the contribution of fall risk, impact loading and femoral strength to hip fracture, that is needed to enable the design of interventions that might be effective in fall prevention and thus, reduce the burden of hip fractures.

项目总结