title: Poor nutritional status is associated with a higher risk of falling and fracture in elderly people living at home in France: the Three-City cohort study.
abstract: Falling and fractures are a public health problem in elderly people. The aim of our study was to investigate whether nutritional status is associated with the risk of falling or fracture in community-dwelling elderly. Poor nutritional status was significantly associated with a higher risk of both falling and fractures.
  
  
  BACKGROUND
  Nutrition could play a role to prevent falls and fractures. The purpose of this study is to investigate whether a poor nutritional status is associated with the risk of falling and of fracture in community dwelling elderly.
  
  
  METHODS
  Baseline nutritional status of participants was assessed using the Mini Nutritional Assessment (MNA). After a follow-up of 12 years, 6040 individuals with available data for falls and 6839 for fracture were included. People who presented the outcomes at baseline were excluded. Cox models were used to evaluate the associations between nutritional status and the risks of fall or fracture.
  
  
  RESULTS
  The frequency of poor nutritional status (MNA ≤ 23.5), at baseline, was respectively 12.0% in the "fall study sample" and 12.8% in the "fracture study sample." Incident fall and fracture over 12 years were reported in 55.8 and 18.5% of the respective samples, respectively. In multivariate models controlled for sociodemographic data and several baseline health indicators, poor nutritional status was significantly associated with a higher risk of falling (hazard ratio (HR) = 1.66, 95% confidence interval (95% CI) 1.35-2.04 in men and HR = 1.20, 95% CI 1.07-1.34 in women) and with a higher risk of fracture (HR = 1.28, 95% CI 1.09-1.49).
  
  
  CONCLUSIONS
  Poor nutritional status was associated with a higher risk of both falling and fractures in French elderly community-dwellers. Early screening and management of the nutritional status may be useful to reduce the frequency of these events in older people.
authors: Univ. Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, F-33000, Bordeaux, France, Marion.Torres@isped.u-bordeaux2.fr.
authors: M J
authors: MJ
authors: Torres
authors: C
authors: C
authors: Féart
authors: C
authors: C
authors: Samieri
authors: B
authors: B
authors: Dorigny
authors: Y
authors: Y
authors: Luiking
authors: C
authors: C
authors: Berr
authors: P
authors: P
authors: Barberger-Gateau
authors: L
authors: L
authors: Letenneur
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D015331:Cohort Studies; D058620:Elder Nutritional Physiological Phenomena / Q000502:physiology; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D009752:Nutritional Status / Q000502:physiology*; D058866:Osteoporotic Fractures / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D012111:Residence Characteristics; D012307:Risk Factors