Persistent hypovitaminosis D and loss of hip bone mineral density over time as additional risk factors for recurrent falls in a population-based prospective cohort of elderly persons living in the community. The Sao Paulo Ageing & Health (SPAH) Study

Carregando...
Imagem de Miniatura
Citações na Scopus
6
Tipo de produção
article
Data de publicação
2015
Título da Revista
ISSN da Revista
Título do Volume
Editora
SPRINGER LONDON LTD
Citação
OSTEOPOROSIS INTERNATIONAL, v.26, n.5, p.1535-1542, 2015
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
A Summary We performed concomitant evaluation of clinical, laboratory, and bone mineral density (BMD) parameters as potential risk factors for falls in a population-based prospective cohort of older adults, since previous studies have focused mostly in clinical risk factors. Loss of hip BMD and persistent hypovitaminosis D were associated with recurrent falls in community-dwelling elderly. Introduction Few studies have performed a concomitant evaluation of clinical data, laboratory bone parameters, and bone mineral density (BMD) to determine more accurately the contribution of each of these variables to risk of falls in elderly persons. We investigated the association between bone parameters and recurrent falls in a population-based prospective cohort of community-dwelling older adults. Methods A total of 705 elderly individuals (448 women, 257 men) were evaluated with clinical data, BMD, and laboratory bone tests at baseline and after a mean follow-up of 4.3 +/- 0.8 years. Individuals with recurrent falls (a parts per thousand yen2 falls in the previous year from the date of the second evaluation) were considered chronic fallers. Logistic regression models were used to identify independent risk factors for recurrent falls. Results The frequency of chronic fallers was 16.5 %. In multivariate analyses, risk factors for recurrent falls were visual impairment (odds ratio (OR) = 2.49, 95 % confidence interval (CI) 1.30-4.74, p = 0.006), use of psychotropic drugs (OR = 2.47, 95 % CI 1.37-4.49, p = 0.003), clinical fracture (OR = 2.78, 95 % CI 1.48-5.20, p = 0.001), persistently low 25-hydroxyvitamin D (25OHD) (< 20 ng/mL) (OR = 1.71, 95 % CI 1.10-2.64, p = 0.016), and loss of total hip BMD during the study (OR = 1.21, 95 % CI 1.17-1.25, p = 0.035 for each 4 % decrease). Conclusions In addition to traditional clinical risk factors for falls, loss of hip BMD and hypovitaminosis D were associated with recurrent falls in community-dwelling elderly persons. Thus, recognizing these factors is essential to preventing falls and improving the outcomes of this population.
Palavras-chave
Bone mineral density, Elderly, Recurrent falls, Risk factors, Vitamin D
Referências
  1. Lundebjerg N, 2001, J AM GERIATR SOC, V49, P664
  2. Annweiler C, 2015, J INTERN MED, V277, P16, DOI 10.1111/joim.12250
  3. Beaudart C, 2014, J CLIN ENDOCR METAB, V99, P4336, DOI 10.1210/jc.2014-1742
  4. Bischoff HA, 2003, J BONE MINER RES, V18, P343, DOI 10.1359/jbmr.2003.18.2.343
  5. Bischoff HA, 2001, HISTOCHEM J, V33, P19, DOI 10.1023/A:1017535728844
  6. Bischoff-Ferrari HA, 2006, OSTEOPOROSIS INT, V17, P656, DOI 10.1007/s00198-005-0030-9
  7. Broe KE, 2007, J AM GERIATR SOC, V55, P234, DOI 10.1111/j.1532-5415.2007.01048.x
  8. Ceglia L, 2013, J CLIN ENDOCR METAB, V98, pE1927, DOI 10.1210/jc.2013-2820
  9. Cesari M, 2002, J GERONTOL A-BIOL, V57, pM722
  10. COCKCROFT DW, 1976, NEPHRON, V16, P31, DOI 10.1159/000180580
  11. de Deco CP, 2007, GERODONTOLOGY, V24, P136
  12. Domiciano DS, 2013, OSTEOPOROSIS INT, V24, P595, DOI 10.1007/s00198-012-2002-1
  13. Domiciano DS, 2014, OSTEOPOROSIS INT, V25, P2805, DOI 10.1007/s00198-014-2821-3
  14. Ensrud KE, 2002, J AM GERIATR SOC, V50, P1629, DOI 10.1046/j.1532-5415.2002.50453.x
  15. Ensrud KE, 2007, J GERONTOL A-BIOL, V62, P744
  16. Espino DV, 2000, J AM GERIATR SOC, V48, P1252
  17. Figueiredo CP, 2014, OSTEOPOROSIS INT, V25, P589, DOI 10.1007/s00198-013-2455-x
  18. GENANT HK, 1993, J BONE MINER RES, V8, P1137
  19. Hartholt KA, 2011, PLOS ONE, V6, DOI 10.1371/journal.pone.0022227
  20. Henry MJ, 2006, RADIOLOGY, V241, P190, DOI 10.1148/radiol.2411051290
  21. Holick MF, 2011, J CLIN ENDOCR METAB, V96, P1911, DOI 10.1210/jc.2011-0385
  22. IBGE - Instituto Brasileiro de Geografia e Estatistica, PERF ID RESP PEL DOM
  23. Jackson C, 2007, QJM-INT J MED, V100, P185, DOI 10.1093/qjmed/hcm005
  24. Kabeshova A, 2014, AGING CLIN EXP RES, V26, P331, DOI 10.1007/s40520-014-0232-0
  25. Kannus P, 1999, JAMA-J AM MED ASSOC, V281, P1895, DOI 10.1001/jama.281.20.1895
  26. Larsen ER, 2005, AGING CLIN EXP RES, V17, P125
  27. LeBoff MS, 2008, OSTEOPOROSIS INT, V19, P1283, DOI 10.1007/s00198-008-0582-6
  28. Lima-Costa MF, 2003, CAD SAUDE PUBLICA, V19, P700, DOI 10.1590/S0102-311X2003000300001
  29. Lopes JB, 2011, OSTEOPOROSIS INT, V22, P711, DOI 10.1007/s00198-010-1258-6
  30. United Nations, 2004, WORLD POP PROSP 2004
  31. Maeda Sergio Setsuo, 2013, Dermatoendocrinol, V5, P211, DOI 10.4161/derm.24476
  32. Mathias Thais Aidar de Freitas, 2006, Rev Lat Am Enfermagem, V14, P17, DOI 10.1590/S0104-11692006000100003
  33. Menant JC, 2012, OSTEOPOROSIS INT, V23, P981, DOI 10.1007/s00198-011-1637-7
  34. OLOUGHLIN JL, 1993, AM J EPIDEMIOL, V137, P342
  35. Parry SW, 2001, POSTGRAD MED J, V77, P103, DOI 10.1136/pmj.77.904.103
  36. Perracini MR, 2002, REV SAUDE PUBL, V36, P709, DOI 10.1590/S0034-89102002000700008
  37. Pinheiro MD, 2010, CAD SAUDE PUBLICA, V26, P89, DOI 10.1590/S0102-311X2010000100010
  38. Pluijm SMF, 2006, OSTEOPOROSIS INT, V17, P417, DOI 10.1007/s00198-005-0002-0
  39. Reyes-Ortiz CA, 2005, REV PANAM SALUD PUBL, V17, P362
  40. Rozenfeld Suely, 2003, Rev Panam Salud Publica, V13, P369, DOI 10.1590/S1020-49892003000500005
  41. Sarkisian CA, 2000, J AM GERIATR SOC, V48, P170
  42. Schousboe JT, 2013, J CLIN DENSITOM, V16, P455, DOI 10.1016/j.jocd.2013.08.004
  43. Schwartz AV, 1999, J AM GERIATR SOC, V47, P1371
  44. Snijder MB, 2006, J CLIN ENDOCR METAB, V91, P2980, DOI 10.1210/jc.2006-0510
  45. Suzuki T, 2008, J BONE MINER RES, V23, P1309, DOI [10.1359/jbmr.080328, 10.1359/JBMR.080328]
  46. TINETTI ME, 1988, NEW ENGL J MED, V319, P1701, DOI 10.1056/NEJM198812293192604
  47. Tromp AM, 1998, J BONE MINER RES, V13, P1932, DOI 10.1359/jbmr.1998.13.12.1932
  48. Young Y, 2001, J AGING HEALTH, V13, P511, DOI 10.1177/089826430101300404