Older women with osteoporosis have increased postural sway and weaker quadriceps strength than counterparts with normal bone mass: overlooked determinants of fracture risk?
BACKGROUND
Fracture risk is determined by both bone health and fall risk. Evidence suggests that older women with osteoporosis may have a greater risk of falling compared with their age-matched counterparts without osteoporosis ( 1). To determine whether fall risk screening should be a routine part of medical assessment in older women with osteoporosis, a comparison of fall risk between those with osteoporosis and healthy age-matched counterparts is needed. The purpose of this study was to compare 3 established fall risk factors between these 2 groups of women.


METHODS
42 women between the ages of 64 and 75 years old participated in this study. 21 women with osteoporosis were matched by age and current physical activity level to 21 women without osteoporosis. The performance on 3 fall risk factors (quadriceps strength, balance, and functional mobility) was compared between the 2 groups using multivariate analysis of variance. The level of significance was set at p <or=.05.


RESULTS
There was an overall difference between the 2 groups on the fall risk factors (Wilk's lambda = 0.769, p =.018). Dominant quadriceps strength and composite balance score were, respectively, 18% significantly less and 11% worse in women with osteoporosis than those without. Functional mobility was not significantly different between the 2 groups.


CONCLUSIONS
This study highlights older women with osteoporosis as a high fracture risk group due to having both lower bone density, and possibly, higher fall risk compared with their age-matched counterparts without osteoporosis. Both fall risk screening and fall risk reduction may be prudent to prevent fractures in women with osteoporosis.
Liu-Ambrose
Teresa
T
School of Human Kinetics, University of British Columbia, Vancouver, Canada.
Eng
Janice J
JJ
Khan
Karim M
KM
Carter
Nick D
ND
McKay
Heather A
HA
D000058:Accidental Falls / Q000706:statistics & numerical data*; D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D015519:Bone Density / Q000502:physiology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005598:Fractures, Spontaneous / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D015999:Multivariate Analysis; D018908:Muscle Weakness; D018482:Muscle, Skeletal / Q000502:physiology*; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis* / Q000453:epidemiology; D011187:Posture; D011336:Probability; D018570:Risk Assessment; D013848:Thigh