Low bone mass and postfall fracture risk among elderly nursing home men.
OBJECTIVE
To study postfall fracture risk in relation to bone mineral density.


METHODS
The study was conducted in men residing in nursing homes.


METHODS
A total of 212 men above the age of 65 years were recruited, and of these, 172 satisfied the inclusion criteria of the study. Among them, 82 were less than 85 years old, and 90 were at least 85 years old.


METHODS
Bone mineral density (BMD) of the calcaneus was measured, using the Lunar PIXI Bone Densitometer (version 1.43) and charts were reviewed for age, falls, and fractures.


METHODS
The values of BMD were expressed as T-scores, and the Lunar criteria equivalents of T-scores were used (T-scores more than -0.6 for normal BMD, -0.6 to -1.6 for osteopenia, and below -1.6 for osteoporosis).


RESULTS
The median age of all participants was 84 years (range 65 to 102 years), and their mean T-score at the calcaneus was -1.51. In about 51% of them, the T-score was in the osteoporotic range. For subjects less than 85 years old, the mean T-score was -1.19, and for those 85 years and older, the mean T-score was -1.81; the mean bone density of those in the older old group was significantly lower than those in the younger old group if there was a history of a fracture. Analysis by age quartiles showed a progressive decline in BMD with advancing age. About 53% of the subjects who fell (37.2%) sustained a nontraumatic fracture. Among them, 67.6% had osteoporosis.


CONCLUSIONS
At any given age after age 65, men who sustained a postfall fracture had a significantly lower BMD than those who did not sustain a postfall fracture.
Toofanny
Nizaamuddeen
N
William Beaumont Hospital, Royal Oak, Michigan 48703, USA. ntoofanny@pol.net
Maddens
Michael E
ME
Voytas
John
J
Kowalski
Debra
D
D015502:Absorptiometry, Photon; D000058:Accidental Falls / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D050723:Fractures, Bone / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D006707:Homes for the Aged / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data; D010024:Osteoporosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D015995:Prevalence; D016016:Proportional Hazards Models; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D014481:United States / Q000453:epidemiology