Persistent hypovitaminosis D and loss of hip bone mineral density over time as additional risk factors for recurrent falls in a population-based prospective cohort of elderly persons living in the community. The Sao Paulo Ageing & Health (SPAH) Study

Autor(es)

Machado, K. L. L. L. ^[1] ; Domiciano, D. S. ^[1] ; Machado, L. G. ^[1] ; Lopes, J. B. ^[1] ; Figueiredo, C. P. ^[1] ; Takayama, L. ^[1] ; Oliveira, R. M. ^[2] ; Menezes, P. R. ^[3] ; Pereira, R. M. R. ^[1]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Fac Med, Div Rheumatol, Bone Metab Lab, BR-01246903 Sao Paulo, SP - Brazil

^[2] RDO Diagnost Med, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Fac Med, Dept Prevent Med, BR-01246903 Sao Paulo, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: OSTEOPOROSIS INTERNATIONAL; v. 26, n. 5, p. 1535-1542, MAY 2015.
• Citações Web of Science: 3

Resumo

A Summary We performed concomitant evaluation of clinical, laboratory, and bone mineral density (BMD) parameters as potential risk factors for falls in a population-based prospective cohort of older adults, since previous studies have focused mostly in clinical risk factors. Loss of hip BMD and persistent hypovitaminosis D were associated with recurrent falls in community-dwelling elderly. Introduction Few studies have performed a concomitant evaluation of clinical data, laboratory bone parameters, and bone mineral density (BMD) to determine more accurately the contribution of each of these variables to risk of falls in elderly persons. We investigated the association between bone parameters and recurrent falls in a population-based prospective cohort of community-dwelling older adults. Methods A total of 705 elderly individuals (448 women, 257 men) were evaluated with clinical data, BMD, and laboratory bone tests at baseline and after a mean follow-up of 4.3 +/- 0.8 years. Individuals with recurrent falls (a parts per thousand yen2 falls in the previous year from the date of the second evaluation) were considered chronic fallers. Logistic regression models were used to identify independent risk factors for recurrent falls. Results The frequency of chronic fallers was 16.5 %. In multivariate analyses, risk factors for recurrent falls were visual impairment (odds ratio (OR) = 2.49, 95 % confidence interval (CI) 1.30-4.74, p = 0.006), use of psychotropic drugs (OR = 2.47, 95 % CI 1.37-4.49, p = 0.003), clinical fracture (OR = 2.78, 95 % CI 1.48-5.20, p = 0.001), persistently low 25-hydroxyvitamin D (25OHD) (< 20 ng/mL) (OR = 1.71, 95 % CI 1.10-2.64, p = 0.016), and loss of total hip BMD during the study (OR = 1.21, 95 % CI 1.17-1.25, p = 0.035 for each 4 % decrease). Conclusions In addition to traditional clinical risk factors for falls, loss of hip BMD and hypovitaminosis D were associated with recurrent falls in community-dwelling elderly persons. Thus, recognizing these factors is essential to preventing falls and improving the outcomes of this population. (AU)

• Processo FAPESP: 09/15346-4 - Incidência de fraturas vertebrais e fraturas clínicas não vertebrais em uma população de indivíduos de 65 anos ou mais
• Beneficiário: Rosa Maria Rodrigues Pereira
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 03/09313-0 - Prevalência de osteoporose, fraturas vertebrais e não vertebrais em uma população feminina, de 65 anos ou mais na área do Butantã
• Beneficiário: Rosa Maria Rodrigues Pereira
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 04/12694-8 - Incidência de demência e declínio cognitivo em idosos de baixa renda em São Paulo: estudo de coorte
• Beneficiário: Isabela Judith Martins Bensenor
• Modalidade de apoio: Auxílio à Pesquisa - Regular