title: Fall-related risk factors and heel quantitative ultrasound in the assessment of hip fracture risk: a 10-year follow-up of a nationally representative adult population sample.
abstract: Maximal walking speed and quantitative ultrasound index (QUI) were significant and independent predictors of hip fracture among subjects aged ≥ 55 years. A model including readily available variables along with simple fall-related factors may be clinically useful in the assessment of hip fracture risk even without a QUI measurement.
  
  
  BACKGROUND
  This study assessed fall-related risk factors along with heel bone quantitative ultrasound (QUS) measurements for the prediction of hip fracture during a mean follow-up of 9.8 years in a nationally representative population sample.
  
  
  METHODS
  The study population consisted of 2,300 subjects (1,331 women and 969 men) aged 55 years or over, who had participated in a comprehensive health survey in 2000-2001. Information on the subjects’ health and fall-related risk factors was obtained with interviews, questionnaires and tests carried out by specially trained professionals. QUS measurements were made by means of the Hologic Sahara device. First emerging cases of hip fracture were identified from the National Hospital Discharge Register.
  
  
  RESULTS
  During the follow-up, 96 subjects sustained a hip fracture. Slow maximal walking speed, low quantitative ultrasound index (QUI), high age, tallness, short waist circumference, Parkinson's disease and the number of central nervous system active medication were significant and independent predictors of hip fracture. The model including all of these risk factors explained 68 % of the variation in hip fracture risk. Excluding QUI from this model reduced the percentage to 66%.
  
  
  CONCLUSIONS
  Maximal walking speed and QUI were significant and independent predictors of hip fracture. A model including readily available variables such as age, gender, height and waist circumference along with simple fall-related factors may be of clinical use in the assessment of hip fracture risk even without a QUS measurement.
authors.forename: M
authors.initials: M
authors.lastname: Kauppi
authors.forename: S
authors.initials: S
authors.lastname: Stenholm
authors.forename: O
authors.initials: O
authors.lastname: Impivaara
authors.forename: J
authors.initials: J
authors.lastname: Mäki
authors.forename: M
authors.initials: M
authors.lastname: Heliövaara
authors.forename: A
authors.initials: A
authors.lastname: Jula
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D000886:Anthropometry / Q000379:methods; D002111:Calcaneus / Q000000981:diagnostic imaging*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D018737:Hand Strength; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012737:Sex Factors; D014463:Ultrasonography; D016138:Walking / Q000502:physiology