title: Ultrasound measurements for the prediction of osteoporotic fractures in elderly people.
abstract: In this prospective study we investigated the predictive value of quantitative ultrasound (QUS) measurements and other potential predictors of osteoporotic fractures in the elderly. During a 1-year period, 710 participants (132 men and 578 women), aged 70 years and older (mean age +/- SD: 82.8 +/- 5.9), were recruited from seven homes and apartment houses for the elderly. QUS measurements (broadband ultrasound attenuation (BUA) and speed of sound (SOS)) were assessed with a clinical bone densitometer. A structured questionnaire was used to collect information on other potential predictors. Follow-up of fractures was done each half year by telephone interviews. During the study period (median follow-up 2.8 years, maximum 3.7 years), 30 participants had a first hip fracture and 54 suffered from a first other nonspinal fracture. Cox regression analyses, adjusted for age and sex, showed that the relative risk (RR) of hip fracture for each standard deviation reduction was 2.3 (95% CI, 1.4-3.7) for BUA and 1.6 (95% CI, 1.1-2.3) for SOS. Slightly weaker relationships were found for any fracture (BUA: RR, 1.6; 95% CI, 1.2-2.1; SOS: RR, 1.3; 95% CI, 1.0-1.6). Multivariable analyses identified low BUA values and immobility as the strongest predictors for hip fractures and any fracture. Female gender proved to be the strongest predictor for other nonspinal fractures. It can be concluded that QUS measurements can predict the risk for hip fracture and any fracture in elderly people.
authors.affiliation: Institute of Research in Extramural Medicine (EMGO Institute), Vrije Universiteit, Amsterdam, The Netherlands.
authors.forename: S M
authors.initials: SM
authors.lastname: Pluijm
authors.forename: W C
authors.initials: WC
authors.lastname: Graafmans
authors.forename: L M
authors.initials: LM
authors.lastname: Bouter
authors.forename: P
authors.initials: P
authors.lastname: Lips
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002111:Calcaneus / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000209:etiology*; D006620:Hip Fractures / Q000209:etiology; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000150:complications* / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012044:Regression Analysis; D012306:Risk; D012737:Sex Factors; D014463:Ultrasonography