ASSESSING OSTEOPOROSIS RISK

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。很少有研究已经完成，以评估骨质疏松症的评估或诊断水平，骨量测量或贡献者的骨质流失和跌倒风险的辅助生活社区的居民。 假设和具体目的1）居住在辅助生活的个人相对于社区居住的老年人，骨质疏松症的评估或诊断率较低。我们将调查个人的历史和骨质疏松症的评估辅助生活，并比较一组年龄和性别匹配的社区居住成年人2）居住在辅助生活的个人将有低骨量，通过足跟超声测量，与社区居住的老年人相比。将使用定量超声评估骨量。3)僵硬指数T评分将与促钙激素相关（与25 OHD直接相关，与PTH相反），并与身体表现指标（握力、步行速度和身体活动）直接相关。研究设计：对79名辅助生活的居民进行横断面分析，并与79名年龄和性别匹配的社区居住成年人进行比较。研究志愿者将接受使用足跟超声的骨评估，评估骨折史和既往骨质疏松症评估的问卷调查，前6个月内的福尔斯，钙、维生素D和蛋白质的饮食摄入，并将进行身体表现测量，包括握力和步行速度。 在先前对55名社区居住老年男性（平均年龄73 ± 8岁）的研究中，发现僵硬指数T评分与体力活动评分（r=.30，p =.043）、步行速度（r=-.37，p=.006）和握力趋势（r=.24，p=.07）之间存在相关性。根据之前的工作，我们计算出我们需要评估158个受试者。将使用列联表方法，将生活辅助老年人口中服务不足者的比例与健康非生活辅助老年人口中的比例进行对比。将计算通过足跟超声检测到的骨质疏松症的频率，并与已建立的国家年龄调整的患病率估计值进行比较。相关性分析将用于评估足跟超声、骨矿物质密度、维生素D水平、甲状旁腺激素水平和虚弱指标之间的相关性。对于比例对比，当在5%的显著性水平下进行检验时，79名辅助生活受试者和79名非辅助生活受试者的样本将提供80%的把握度来检测3.0或更高的比值比。当组合时，这些样本还将提供80%的功效来检测大于+0.22或小于-0.22的相关系数。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Little research has been done to assess the level of osteoporosis evaluation or diagnosis, bone mass measurement or contributors to bone loss and fall risk in residents of assisted living communities. Hypotheses and Specific Aims 1)Individuals residing in assisted living will have a low rate of osteoporosis evaluation or diagnosis relative to community dwelling elders. We will survey individual for history and evaluation of osteoporosis in assisted living and compare to a group of age and gender matched community dwelling adults 2)Individuals residing in assisted living will have low bone mass, measured by heel ultrasound, compared to community dwelling elders. Quantitative ultrasound will be used to assess bone mass. 3)The stiffness index T score will correlate with calciotropic hormones (directly with 25OHD and inversely with PTH) and directly to physical performance measures (hand grip, walking speed and physical activity). Study Design: Cross-sectional analysis of 79 residents of assisted living with a comparison to 79 age and gender-matched community dwelling adults. Research volunteers will undergo bone assessment using heel ultrasound, questionnaires to assess fracture history and previous osteoporosis evaluation, falls in previous 6 months, dietary intake of calcium, vitamin D and protein, and will have physical performance measures including hand grip strength and walking speed. In a previous study of 55 community dwelling older men (mean age 73 + 8 y), correlations were found between stiffness index T score and physical activity score (r=.30,p=.043), walking speed (r=-.37, p=.006) and a trend with handgrip (r=.24, p=.07). Based on this previous work, we calculate that we will need to assess 158 subjects. The proportion of underserved individuals in the assisted-living, elderly population will be contrasted with that in the healthy, non-assisted-living, older population using contingency table methods. The frequency of osteoporosis detected by heel ultrasound will be calculated and compared to established, national, age-adjusted, prevalence estimates. Correlation analysis will be used to evaluate associations between heel ultrasound, bone mineral density, vitamin-D levels, parathyroid hormone levels, and frailty measures. For the contrast of proportions, samples of 79 assisted-living subjects and 79 non-assisted-living subjects will provide 80% power to detect odds ratios of 3.0 or more when testing at the 5% level of significance. When combined, those samples will also provide 80% power to detect correlation coefficients greater than +0.22 or smaller than -0.22.