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Lookup NU author(s): Emerita Professor Julia Newton, Professor David Jones, Katharine Wilton, Jessie Pairman, Dr Steve Parry, Emeritus Professor Roger Francis
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Background: Annually, 35-40% of those aged >65 years fall; up to 5% of such falls result in fracture. Fracture is determined both by propensity to fall and by bone fragility. Aim: To determine osteoporosis prevalence and predictors in patients who have fallen. Design: Observational cross-sectional study. Methods: We measured calcaneal BMD in 408 consecutive patients aged >50 years attending after falling. Fall number, fracture history, weight, height, and risk factors for falls and osteoporosis were recorded. T scores (SD above or below the mean for young adults) were derived in both sexes, and Z scores (SD above or below age-related normal score) in females. Results: In females (n=300, 74%), mean (SD) T score was -1.1(1.6), and mean Z score was 0(1.4); 127 (42%) had osteoporosis (T score < -1.6). ROC curves confirmed significant relationships between osteoporosis and age, weight and height (all < 0.0001). corporating fracture history, our model (fracture aged >50 years, age >83 years, weight <57kg, height <153cm as dichotomous variables) predicted osteoporosis with 91% sensitivity, 34% specificity. Of 108 male fallers, 36 (33%) had osteoporosis. Age, height and weight all predicted osteoporosis (< 0.02). The resulting model (fracture aged >50 years, age ≥80 years, weight ≤68kg, height ≤167cm as dichotomous variables) predicted osteoporosis with 92% sensitivity, 30% specificity. Discussion: Osteoporosis prevalence is not increased in female fallers compared to age-related norms; empirical use of osteoporosis treatment solely on the basis of falls thus appears inappropriate. In both sexes, the factors predicting osteoporosis were age, height and weight. Where BMD is not practical, possible or economical, our model may be a sensitive means of predicting fallers with osteoporosis. © 2006 Oxford University Press.
Author(s): Newton JL, Jones DEJ, Wilton K, Pairman J, Parry SW, Francis RM
Publication type: Article
Publication status: Published
Journal: QJM
Year: 2006
Volume: 99
Issue: 4
Pages: 231-236
ISSN (print): 1460-2725
ISSN (electronic): 1460-2393
Publisher: Oxford University Press
URL: http://dx.doi.org/10.1093/qjmed/hcl0261093
DOI: 10.1093/qjmed/hcl026
PubMed id: 16565521
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