ASSESSING OSTEOPOROSIS RISK

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 很少有研究评估辅助生活社区居民的骨质疏松症评估或诊断水平、骨量测量或骨丢失和跌倒风险的贡献者。假设和具体目标1)与社区居住的老年人相比，居住在辅助生活中的个人将有较低的骨质疏松症评估或诊断比率。我们将调查个人辅助生活中骨质疏松的历史和评估，并与一组年龄和性别匹配的社区居住成年人进行比较2)与社区居住老年人相比，居住在辅助生活中的个人的跟部超声波测量的骨量将较低。定量超声将用于评估骨量。3)僵硬指数T分与促钙激素(与25OHD呈正相关，与甲状旁腺素呈负相关)、与体能指标(握手、步行速度、体力活动)呈正相关。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成年人进行比较。研究志愿者将接受使用脚跟超声进行的骨骼评估，评估骨折史和既往骨质疏松症评估的问卷，过去6个月内摔倒，饮食中钙、维生素D和蛋白质的摄入量，并将进行包括握力和步行速度在内的体能测试。在之前对55名居住在社区的老年男性(平均年龄73±8岁)的研究中，僵硬指数T得分与体力活动得分(r=.30，p=.043)、步行速度(r=-.37，p=.006)以及握力趋势(r=.24，p=0.07)之间存在相关性。基于前面的工作，我们计算出我们将需要评估158个科目。将使用列联表方法，将有辅助性生活的老年人口中未得到充分服务的个人比例与健康的非辅助性生活的老年人口中的比例进行对比。足跟超声检测到的骨质疏松症的频率将被计算出来，并与既定的、国家的、年龄调整的患病率估计进行比较。相关分析将被用来评估足跟超声、骨密度、维生素D水平、甲状旁腺激素水平和脆弱指标之间的关系。为了对比比例，79名生活辅助对象和79名非生活辅助对象的样本在5%的显著性水平上进行测试时，将提供80%的能力来检测3.0或更高的优势比。当组合时，这些样本还将提供80%的功率来检测大于+0.22或小于-0.22的相关系数。合作伙伴

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