title: Osteoporosis risk in frail older adults in assisted living.
abstract: OBJECTIVE
  To compare osteoporosis risk in residents of assisted living (AL) with that of age- and sex-matched community-dwelling adults.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Community and AL facilities in Connecticut.
  
  
  METHODS
  One hundred seven individuals (77 control, 37 AL).
  
  
  METHODS
  Fracture and osteoporosis evaluation history, qualitative heel ultrasound (QUS), 25-hydroxyvitamin D (25OHD), parathyroid hormone (PTH), and physical function measures, including walking speed, chair rise time, 6-minute walk, Berg Balance Scale, Get Up and Go, and handgrip strength.
  
  
  RESULTS
  Participants' mean age was 82.7+/-5.7. There were no group differences in reported fracture, diagnosis of osteoporosis, or previous bone mineral density (BMD) assessment. QUS T-scores were -1.0+/-1.5 for community living and -1.9+/-1.3 for AL (P=.002), 25OHD levels were 113.0+/-40.1 nnmol/L for community living and 81.8+/-36.9 for AL (P<.001), and PTH levels were 50.8+/-29.8 pg/mL for community living and 58.8+/-32.8 pg/mL for AL (P=.22). Physical performance was more impaired in AL (P<.05), except for single leg stance (P=.16). In linear regression analysis, age, sex, and site of residence were significant predictors of heel T-score, explaining 53.7% of the variance.
  
  
  CONCLUSIONS
  Residents of AL did not report less fracture or osteoporosis than those from the community, but risk factors measured directly were significantly different, including lower BMD and 25OHD and more impairment in measures of physical function. These data suggest that residents of AL are at greater risk for osteoporotic fracture and that measures to diminish risk (optimizing vitamin D status, implementing fall prevention strategies, incorporating exercise to improve physical performance) should be considered and studied for benefit.
authors.affiliation: University of Connecticut Health Center, Farmington, Connecticut 06030-5215, USA. Kenny@uchc.edu
authors.forename: Anne M
authors.initials: AM
authors.lastname: Kenny
authors.forename: JoAnne
authors.initials: J
authors.lastname: Smith
authors.forename: Emre
authors.initials: E
authors.lastname: Noteroglu
authors.forename: Ilana Y
authors.initials: IY
authors.lastname: Waynik
authors.forename: Cynthia
authors.initials: C
authors.lastname: Ellis
authors.forename: Alison
authors.initials: A
authors.lastname: Kleppinger
authors.forename: Kristen
authors.initials: K
authors.lastname: Annis
authors.forename: Debrorah
authors.initials: D
authors.lastname: Dauser
authors.forename: Stephen
authors.initials: S
authors.lastname: Walsh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D040561:Assisted Living Facilities / Q000706:statistics & numerical data*; D015519:Bone Density; D003430:Cross-Sectional Studies; D005260:Female; D016330:Frail Elderly; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000453:epidemiology*; D012111:Residence Characteristics; D012307:Risk Factors