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  • 1
    Digitale Medien
    Digitale Medien
    Predictors of Fractures in Elderly Women (2000)
    Springer
    Osteoporosis international 11 (2000), S. 134-140 
    Details
    ISSN: 1433-2965
    Schlagwort(e): Key words:Biochemical markers – Bone mineral density – Hip fractures – Loop diuretics – Low mobility – Osteoporotic fractures
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract: In a prospective study of 348 apparently healthy women, aged 70 years and over (mean 80.3 years), we examined bone mineral density (BMD), biochemical markers of bone metabolism, and some easily measurable predictors in relation to hip and osteoporotic fractures. In addition, we constructed risk profiles for hip and osteoporotic fractures. At baseline, BMD at both hips, using dual-energy X-ray absorptiometry, body height and body weight were measured. At the same time, serum and urine samples were obtained for biochemical analysis. Serum samples were analyzed for vitamin D metabolites, sex hormone binding globulin, serum intact parathyroid hormone, osteocalcin, alkaline phosphatase, phosphate, albumin, calcium and creatinine. In 2 h fasting urine, hydroxyproline, type I collagen crosslinked N-telopeptide (NTx) and calcium excretion were measured. Furthermore, easily measurable predictors, such as previous fracture, body mass index (BMI) and mobility were assessed. During the follow-up period (mean duration 5.0 years), hip and any osteoporotic fracture (wrist, humerus or hip fracture) occurred in 16 and 33 participants, respectively. Data were analyzed using Cox regression analysis. BMD of the trochanter (per 1 SD decrease) and previous fracture were most strongly associated with hip fractures (adjusted relative risk (RR) = 3.0, 95% confidence interval (CI): 1.4–6.6; RR = 4.2, 95% CI: 1.5–11.6, respectively) and osteoporotic fractures (RR = 1.8, 95% CI: 1.1–2.8; RR = 2.9, 95% CI: 1.5–5.7, respectively). Previous fracture, BMI and mobility were identified as easily measurable predictors for hip fractures, whereas previous fracture, use of loop diuretics and age were predictors for osteoporotic fractures in the risk profile model. The risk of fractures can be predicted with three easily measurable predictors. This study confirms the importance of previous fracture as a predictor for hip fractures and other fractures. It also shows that the use of loop diuretics is a predictor for osteoporotic fractures.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/PL00004174
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    Digitale Medien
    Digitale Medien
    The incidence of hip fractures in independent and institutionalized elderly people (1994)
    Springer
    Osteoporosis international 4 (1994), S. 6-10 
    Details
    ISSN: 1433-2965
    Schlagwort(e): Elderly people ; Hip fractures ; Osteoporosis ; Residence
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The incidence density of hip fractures in the population of Amsterdam, aged 70 years and over, was studied according to the type of residence. In 1989, 655 patients were admitted to nine hospitals within Amsterdam for a hip fracture. Postal codes were used to classify the residence of the population and the hip fracture cases as independent, home for the elderly or nursing home. Stepwise logistic regression was used for data analysis. The risk of hip fracture increased with age and was 1.7 times higher for women than for men. In the age group 70–74 years the relative risk (RR) was 7.6 for those in homes for the elderly and 5.8 for those in nursing homes, when compared with the independent elderly. This RR was approximately 1 for those in homes for the elderly aged 85 years and over. However, in nursing homes the RR was still 2.8 in the age group 95+. We concluded that, despite protective measures against falls, the institutionalized elderly are at greater risk of hip fracture than the independent elderly of the same age and sex. This higher risk is especially apparent in the ‘younger’ age groups.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF02352254
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  • 3
    Digitale Medien
    Digitale Medien
    Different risk profiles for hip fractures and distal forearm fractures: A prospective study (1996)
    Springer
    Osteoporosis international 6 (1996), S. 427-431 
    Details
    ISSN: 1433-2965
    Schlagwort(e): Elderly people ; Fracture prediction ; Hip fractures ; Risk indicators
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract In a prospective cohort of elderly persons, aged 70 years and over, we examined risk indicators for which data could be easily obtained, to construct risk profiles for hip fractures and distal forearm fractures. Participants lived independently, in apartment houses for the elderly or in homes for the elderly. At baseline, information was obtained in 2578 subjects on age, gender, residence, mobility and the frequency of going outdoors. Mobility was measured using a walking score ranging from 1 (not able to walk independently) to 3 (able to walk independently for a fair distance). During the study period (median duration 3.5 years, maximum 4 years) 106 participants sustained a hip fracture and 60 participants suffered a distal forearm fracture. Women compared with men, adjusted for age, had a higher risk of hip fracture (adjusted relative risk (RR)=2.4, 95% confidence interval (CI) 1.3–4.3) and distal forearm fracture (RR=3.7, 95% CI 1.5–9.2). Age, adjusted for gender, was related to hip fractures only: the relative risk of fracture for those in the highest age category (〉85 years) was 9.5 (95% CI 4.3–21.2) compared with those in the lowest age category (70–75 years). Moderately impaired walking ability compared with normal walking ability, adjusted for age and gender, was associated with a higher risk of hip fracture (RR=1.8, 95% CI 1.2–2.7) but with a lower risk of distal forearm fracture (RR=0.4, 95% CI 0.2–0.8). The outdoor score, adjusted for age and gender, was associated with distal forearm fractures only: going outdoors less than once a week, compared with three times or more, was associated with a lower risk of fractures (RR=0.3, 95% CI 0.1–0.9). In those living in homes for the elderly the risk of hip fracture was higher compared with those living independently (RR=2.4, 95% CI 1.4–4.2), adjusted for age and gender. Risk profiles were constructed using stepwise Cox's proportional-hazards regression. The risk profile predicted probabilites of sustaining a hip fracture in a 4-year period ranging from 0.4% to 25.9%, and of distal forearm fractures ranging from 0.2% to 4.5%, depending on the subject's characteristics as defined by the risk indicators. We conclude that easily obtainable risk indicators can be used in the prediction of fractures and can discriminate among fracture types.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01629573
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