Osteoporosis International

, Volume 20, Issue 1, pp 105–112

Role of quantitative ultrasound to predict fracture among institutionalised older people with a history of fracture

  • J. S. Chen
  • L. M. March
  • R. G. Cumming
  • I. D. Cameron
  • J. M. Simpson
  • S. R. Lord
  • P. N. Sambrook
Original Article

DOI: 10.1007/s00198-008-0638-7

Cite this article as:
Chen, J.S., March, L.M., Cumming, R.G. et al. Osteoporos Int (2009) 20: 105. doi:10.1007/s00198-008-0638-7

Abstract

Summary

The fracture predictive value of quantitative ultrasound (QUS) may be modified by previous fracture status. Non-significant associations between QUS parameters and fracture risk were observed among frail older people with a history of fracture. These findings suggest that QUS measurements for frail older people might be more useful in those without a fracture history.

Introduction

Quantitative ultrasound has been shown to predict risk of fracture in various populations. However, this ability may be modified by the presence of previous fracture in very frail older people.

Methods

We assessed bone strength by QUS and clinical risk factors at baseline for 1,982 institutionalised older people. Fractures were ascertained for 2 years from baseline and validated by X-ray reports.

Results

Study participants were very old (mean age = 85.7 ± 7.1 years) and frail (70% using walking aids). Forty-five percent reported a history of fracture. During a mean follow-up period of 1.64 years, 335 participants suffered a fracture or fractures. Fracture rates were significantly higher in participants with a history of fracture compared with those without a history of fracture (16.0 vs 9.2 per 100 person years, p < 0.001). Significant associations between fracture risk and QUS parameters (broadband ultrasound attenuation and velocity of sound) were observed among participants without a history of fracture (both p < 0.01), but not among those who had a fracture history (both p ≥ 0.7).

Conclusions

In very frail older people, QUS measurements may be more useful for assessing fracture risk in those without a history of fracture after age 50.

Keywords

Aged Fractures Osteoporosis Quantitative ultrasound 

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2008

Authors and Affiliations

  • J. S. Chen
    • 1
    • 6
  • L. M. March
    • 1
  • R. G. Cumming
    • 2
  • I. D. Cameron
    • 3
  • J. M. Simpson
    • 4
  • S. R. Lord
    • 5
  • P. N. Sambrook
    • 1
  1. 1.Institute of Bone and Joint ResearchUniversity of SydneySydneyAustralia
  2. 2.Centre for Education and Research on AgeingUniversity of SydneySydneyAustralia
  3. 3.Rehabilitation Studies UnitUniversity of SydneySydneyAustralia
  4. 4.School of Public HealthUniversity of SydneySydneyAustralia
  5. 5.Prince of Wales Medical Research InstituteUNSWSydneyAustralia
  6. 6.Institute of Bone and Joint ResearchRoyal North Shore HospitalSt LeonardsAustralia

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