ASSESSING OSTEOPOROSIS RISK

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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. pard