Literature DB >> 25600475

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 São Paulo Ageing & Health (SPAH) Study.

K L L L Machado1, D S Domiciano, L G Machado, J B Lopes, C P Figueiredo, L Takayama, R M Oliveira, P R Menezes, R M R Pereira.   

Abstract

UNLABELLED: 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 (≥2 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.

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Year:  2015        PMID: 25600475     DOI: 10.1007/s00198-014-3024-7

Source DB:  PubMed          Journal:  Osteoporos Int        ISSN: 0937-941X            Impact factor:   4.507


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7.  Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly.

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8.  Low serum 25-hydroxyvitamin D levels associated with falls among Japanese community-dwelling elderly.

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10.  Discriminating sarcopenia in community-dwelling older women with high frequency of overweight/obesity: the São Paulo Ageing & Health Study (SPAH).

Authors:  D S Domiciano; C P Figueiredo; J B Lopes; V F Caparbo; L Takayama; P R Menezes; E Bonfa; R M R Pereira
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2.  One-legged stance sway of older adults with and without falls.

Authors:  Marcio R Oliveira; Edgar R Vieira; André W O Gil; Karen B P Fernandes; Denilson C Teixeira; Cesar F Amorim; Rubens A da Silva
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Review 3.  Epidemiology of the association between serum 25-hydroxyvitamin D levels and musculoskeletal conditions among elderly individuals: a literature review.

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