ASSESSING OSTEOPOROSIS RISK

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。很少有研究对辅助生活社区居民的骨质疏松评估或诊断水平、骨量测量或骨质流失和跌倒风险的影响因素进行评估。假设与具体目标1)与社区居住长者相比，辅助生活长者的骨质疏松评估或诊断率较低。我们将调查个人在辅助生活中骨质疏松的病史和评估，并与一组年龄和性别匹配的社区居住成年人进行比较。2)与社区居住的老年人相比，生活在辅助生活中的个体将具有较低的骨量。定量超声将用于评估骨量。3)僵硬指数T评分与促钙化激素（与25OHD呈正相关，与PTH呈负相关）和体力表现指标（握力、步行速度和体力活动）直接相关。研究设计：对79名辅助生活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。研究志愿者将使用足跟超声对骨骼进行评估，通过问卷评估骨折史和骨质疏松症评估，过去6个月的跌倒情况，饮食中钙、维生素D和蛋白质的摄入量，并进行包括握力和步行速度在内的体能测试。在先前对55名居住在社区的老年男性（平均年龄73 + 8岁）的研究中，发现僵硬指数T评分与身体活动评分（r= 0.30,p= 0.043）、步行速度（r=- 0.37,p= 0.006）和握力趋势（r= 0.24,p= 0.07）之间存在相关性。基于之前的工作，我们计算出我们将需要评估158个受试者。使用列联表方法，将生活辅助老年人人口中服务不足个人的比例与健康、非生活辅助老年人人口中的比例进行对比。通过脚跟超声检测骨质疏松症的频率将被计算出来，并与已建立的、国家的、年龄调整的患病率估计进行比较。相关分析将用于评估足跟超声、骨密度、维生素d水平、甲状旁腺激素水平和虚弱程度之间的关系。对于比例的对比，在5%显著性水平下，79名生活辅助受试者和79名非生活辅助受试者的样本将提供80%的能力来检测比值比为3.0或更高。当组合在一起时，这些样本也将提供80%的功率来检测大于+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.