title: Epidemiological survey of the feasibility of broadband ultrasound attenuation measured using calcaneal quantitative ultrasound to predict the incidence of falls in the middle aged and elderly.
abstract: We investigated whether calcaneal quantitative ultrasound (QUS-C) is a feasible tool for predicting the incidence of falls.
  
  
  
  Prospective epidemiological cohort study.
  
  
  
  Community-dwelling people sampled in central western Taiwan.
  
  
  
  A cohort of community-dwelling people who were ≥40 years old (men: 524; women: 676) in 2009-2010. Follow-up questionnaires were completed by 186 men and 257 women in 2012.
  
  
  
  Structured questionnaires and broadband ultrasound attenuation (BUA) data were obtained in 2009-2010 using QUS-C, and follow-up surveys were done in a telephone interview in 2012. Using a binary logistic regression model, the risk factors associated with a new fall during follow-up were analysed with all significant variables from the bivariate comparisons and theoretically important variables.
  
  
  
  The incidence of falls was determined when the first new fall occurred during the follow-up period. The mean follow-up time was 2.83 years.
  
  
  
  The total incidence of falls was 28.0 per 1000 person-years for the ≥40 year old group (all participants), 23.3 per 1000 person-years for the 40-70 year old group, and 45.6 per 1000 person-years for the ≥70 year old group. Using multiple logistic regression models, the independent factors were current smoking, living alone, psychiatric drug usage and lower BUA (OR 0.93; 95% CI 0.88 to 0.99, p<0.05) in the ≥70 year old group.
  
  
  
  The incidence of falls was highest in the ≥70 year old group. Using QUS-C-derived BUA is feasible for predicting the incidence of falls in community-dwelling elderly people aged ≥70 years.
authors.affiliation: Department of Family Medicine, Antai Medical Cooperation, Tien Sheng Memorial Hospital, Pingtung, Taiwan.|Department of Nursing, Meiho University, Pingtung, Taiwan.|College of Education, National Kaohsiung Normal University, Kaohsiung, Taiwan.
authors.forename: Ling-Chun
authors.initials: LC
authors.lastname: Ou
authors.affiliation: Departments of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: Yin-Fan
authors.initials: YF
authors.lastname: Chang
authors.affiliation: Departments of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: Chin-Sung
authors.initials: CS
authors.lastname: Chang
authors.affiliation: Institutes of Gerontology, National Cheng Kung University College of Medicine, Tainan, Taiwan.
authors.forename: Ching-Ju
authors.initials: CJ
authors.lastname: Chiu
authors.affiliation: Departments of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: Ting-Hsing
authors.initials: TH
authors.lastname: Chao
authors.affiliation: Departments of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
authors.forename: Zih-Jie
authors.initials: ZJ
authors.lastname: Sun
authors.affiliation: Department of Orthopedics, Tainan Municipal An-Nan Hospital of China Medical University, Tainan, Taiwan.
authors.forename: Ruey-Mo
authors.initials: RM
authors.lastname: Lin
authors.affiliation: Departments of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.|Institutes of Gerontology, National Cheng Kung University College of Medicine, Tainan, Taiwan.|Institutes of Behavioral Medicine, National Cheng Kung University College of Medicine, Tainan, Taiwan.
authors.forename: Chih-Hsing
authors.initials: CH
authors.lastname: Wu
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D001823:Body Composition / Q000502:physiology; D002111:Calcaneus / Q000000981:diagnostic imaging*; D016000:Cluster Analysis; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D014463:Ultrasonography / Q000379:methods
keywords: Falls; calcaneal quantitative ultrasound; incidence; living alone; smoking